Share Your Story for #PaidLeave4CT
Connecticut has successfully joined our surrounding states (NJ, NY, RI, and MA) in passing paid family and medical leave!

Why is this new paid leave law (Public Act No. 19-25) important to you, your family, your business, or your community? Raise your voice and share YOUR story to show why it is important that Connecticut passed paid family and medical leave in 2019.

Then, SHARE this form with 3 of your friends using this link:
Sign in to Google to save your progress. Learn more
Name *
Email *
Phone Number
Zip Code *
Why is paid family and medical leave important to you personally? To your family? To your business? *
How will paid leave benefit Connecticut as a whole?
How would you like to share your story? *
Would you like to subscribe to receive occasional action alerts from the Campaign for Paid Family Leave? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Connecticut.