Student Debt Working Group Survey Question Title * 1. Are you an AFSCME member? Yes No Question Title * 2. Do you have student loan debt? Yes No Question Title * 3. If yes, is the debt: Yours? Your spouse's debt? Your child's/children's? Your grandchild's? Other (please specify) Question Title * 4. Have you heard of the Public Service Loan Forgiveness or Income Based Repayment Programs that are administered by the federal government? Yes No Question Title * 5. Do you know if your loan is: Federal Private Don't know Question Title * 6. Is your student loan debt a financial burden (account for a significant portion of your monthly budget)? Yes No Question Title * 7. Rank your ability to pay your student debt on time: (Reminder: individual survey results will remain confidential.) No problem at all Manageable Occasionally missed or late payments In default Question Title * 8. How many years do you have left before your loan is paid off? 0 - 1 2 - 9 10 - 15 16 - 20 21+ Question Title * 9. Is your student loan payment preventing you from: (Choose all that apply) Buying a home? Preparing for retirement? Paying for your child's college tuition? Going back to school yourself? Starting a family? Other (please specify) Question Title * 10. There are federal programs available specifically to help public service workers pay their student debt. Would you be interested in learning more? If so, provide us the following info below: First Name Last Name Email Zip Code Cell Phone Number Question Title * 11. Would you be willing to: Send a message to a member of Congress? Sign a petition? Join a Webinar? Attend a rally? Question Title * 12. Age: What is your age? 18 - 35 36 - 45 46 - 55 55+ Question Title * 13. What industry do you work in? Corrections/Law Enforcement Early Childhood Education Emergency Services Higher Education Human Service/Public Administration Independent Provider (Home Care, Child Care, Medical Interpreter) Library Worker Nurses Public Works Transportation Other (please specify) Question Title * 14. Does your job require you to have an Associate's degree or higher (Bachelor's degree, Master's degree, Ph.D, etc.)? Yes No Not Sure Question Title * 15. Please include any additional comments here: Done