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1. Name (Confidential)

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2. Where Do You Work? City and/or Town

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3. Where Is Your Physical Worksite? (i.e. 108 Cherry St., Emory Hebard Building)

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4. What Is Your Position/Title?

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5. How Long Have You Been A State/Public Employee?

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6. What Best Describes Your Physical Worksite?

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7. How Many People Work With You At Your Physical Worksite? (i.e. there are 14 people working in my office or on my floor)

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8. Does Your Worksite Have A VSEA Bulletin Board?

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9. If You Have A VSEA Bulletin Board, Is It Updated Regularly?

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10. Have You Had To Move Workplace Locations Within The Past Five Years?

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11. Did You And Your Co-Workers Have Input Into Your Worksite Move?

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12. Are There Temporary Employees Working Where You Do?

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13. If There Are Temporary Employees, Roughly How Many?

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14. Are There Private Contract Employees Where You Work Doing The Same Work As You?

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15. If There Are Private Contractor Employees, Roughly How Many?

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16. Is There A VSEA Leader In Your Workplace?

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17. If There Is A VSEA Leader, Are You Familiar With His/Her Role, Meaning Are They A:

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18. Do You Know Who Represents Your District (i.e. central Vermont, Brattleboro) On The VSEA Board Of Trustees?

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19. Do You Know Who Represents Your Unit (see Q 12 for Units) On The Board Of Trustees?

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20. Do You Know Who Represents Your Work Classification On The VSEA Council?

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21. Do You Know Who Your Chapter President Is?

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22. Do You Know Which VSEA Chapter You Belong To? (i.e. Barre, Bennington, Franklin/Grand Isle, etc.)

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23. Do You Know Who Any Of VSEA's Top Elected Officials Are? (President, First Vice President, Second Vice President, Treasurer, Clerk)

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24. Do You Know Who Your VSEA Steward Is?

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25. How Do You Currently Get To And From Work Daily?

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26. Are You Able To Find Worksite Parking Easily Each Day?

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27. How Do Employees Communicate Best With Each Other At Your Workplace?

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28. Where Do You Get Your Daily News From?

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29. Has Your Workplace Ever Experienced Safety And Health Issues?

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30. Are There Ever Heat/Cold Related Issues At Your Workplace?

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31. Please Finish This Sentence: Management Retaliation Occurs At My Workplace ______

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32. Is Telecommuting In Use At Your Workplace?

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