9to5 Member Survey:
Give us 5 minutes of your time, be entered to win a 1-week stay at a vacation villa anywhere in the world!

Question Title

* 1. Please provide your name and contact information so that we can contact you if you win the 1-week Vacation Getaway:

First Name

Last Name

Address

City

State

Zip

phone

email

Question Title

* 2. Are you a current member of 9to5? Current members are those who have contributed any amount on or after May 1, 2014. To check the status of your membership email 9to5@9to5.org or call 404-222-0001. (NOTE: you MUST be a current dues-paying member to be eligible for the vacation drawing)

yes

no

unsure

Question Title

* 3. Do you have a personal story about being affected by the issues 9to5 works on--issues like unequal pay, paid family leave/sick days, discrimination, harassment, wage theft or low pay?

yes

no

Question Title

* 4. On which issue(s)?

Scheduling

FMLA

Minimum/Living Wages

Paid Sick Days

Welfare/TANF/Safety Net Programs

Family Leave Insurance/Paid Family Leave

Pay Discrimination

Workplace Sexual Harassment

Part time/Temp Work

Race/Sex/Age Discrimination

Wage Theft

Pregnancy Discrimination

Why voting is important to me

Other (please specify)

Question Title

* 5. Can a 9to5 staff organizer follow up with you about this story?

yes

no

If yes, indicate best method of contact (phone #, email address)