1.What is your job or volunteer title?

2.Where do you work?

3.Do you get paid or do you volunteer?

I get paid by the hour

I get paid a salary (minimum wage or higher)

I get paid for a product or service (like a cup of coffee or a piece of art)

I don’t get paid, I volunteer

I get paid and I also volunteer

4.How many hours per week do you work or volunteer?

5.Tell us about your schedule for work or volunteering

6.How do you get to and from the place where you work or volunteer?

I drive myself

Someone else drives me

I ride the bus or other public transit

I use a taxi, Lyft, or Uber

Other (please tell us)

7.Which of these help you work or volunteer? Check all that apply, and tell us more in the text box below.

I use technology (example: iPad or communication device)

I have a job coach or counselor

I use an attendant or other paid staff

I don’t need help

Other (please tell us)

8.If someone helps you do your job, how did you find them and how do they get paid?

9.What did you need to learn to do your job or volunteer position?

10.What steps helped you get the job?

11.What do you do at your job?

12.What does your day at work or volunteering look like?

13.What people do you see every day at work?

14.What do you like about your job?

15.What tips can you share with others about getting your job or doing your job?

16.Use this space to tell us anything more about your work:

17.Include a photo of yourself at work if you would like to:

If you have more than one photo to share, please email amy.litzinger@txp2p.org

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18.Your name:

19.Email:

20.Phone:

21.May we call you to learn more about your story?

Yes

No

22.May we share your email address if others want to ask you questions?

Yes

No

23.Is this story about you or someone else?

This is my story

This is someone else's story