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SEIU 1021 Member Census

The new 1021 Officers and Executive Board are asking you to fill out this survey & tell us about YOUR experience and what’s important to YOU. We’ll use the info to keep the local relevant and responsive to its members’ needs.

**We take our members' privacy seriously. All individual responses will be kept with the strictest confidence**

*First Name and Last Name(Required.)

Birthdate (MM/DD/YYYY)

Gender

What is your ethnicity/race?

Native American or Alaska Native

Asian

Black or African American

Native Hawaiian or Pacific Islander

White

Latinx

Other (please specify)

Do you feel you are getting enough information from your union?

Yes

No

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