Contract Proposal Survey

First name(*)

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Last Name(*)

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Email(*)

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Phone Number(*)

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Address(*)

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City(*)

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State(*)

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Zip Code(*)

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Employer(*)

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Job Title(*)

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How long have you worked for your employer?(*)

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How many hours do you work per week?(*)

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Your Rate of Pay ($/Hour)(*)

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Are you a full-time or part-time employee?(*)

Part-time

Full-time

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Do you work overnight?(*)

Yes

No

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Do you have health insurance through your employer?(*)

Yes

No

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Do you contribute towards the company's 403B retirement plan?(*)

Yes

No

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Please rank the benefits you want Local 338 RWDSU/UFCW to negotiate on your first contract. Rank each line between 1-10 in the order of importance to your concerns: (1 being most important and 10 being the least):

Job Security

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Wage Increases

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Guaranteed Hours

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Medical/Prescription

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Optical

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Dental

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Pension/Annuity

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Vacation

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Personal Time Off

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Seniority

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Health and Safety Checkup

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Childcare Service Reimbursement

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CAPTCHA(*)

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Contract Proposal Survey

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