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* 1. Name

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* 2. Cell Phone

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* 3. Would you like to sign up for text message alerts? (msg and data rates may apply)

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* 4. Email

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* 5. Job Title

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* 6. Worksite

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* 7. Are you currently:

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* 8. Do you think UPW AFSCME Local 646 has been a transparent and effective union?

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* 9. What changes would you like to see in UPW AFSCME Local 646?

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* 10. What do you think are the biggest challenges to making these changes?

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* 11. What have been the main reasons for low member participation in UPW AFSCME Local 646 and how do you think it can be increased?

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* 12. What do you think are UPW AFSCME Local 646’s greatest strengths and weakness?

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* 13. What should be the top priority for UPW administratorship? (check all that apply)

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* 14. Are you willing to help UPW become a stronger union?

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* 15. Additional thoughts or comments?

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* 16. May we follow up with you?

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