JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
UA Member Chat Signup
Please enter your contact information to stay subscribed to the UA Member Chat listserve. All members must enter full name and email below to be added to the new version of the listserve.
Sign in to Google
to save your progress.
Learn more
Last name
Your answer
First name
Your answer
United Academics membership status
Full time faculty UA member
Part time faculty UA member
Retired UA member
Clear selection
Email address (non-UVM email address STRONGLY preferred. Please only enter a UVM email if you do not have another option)
Your answer
Cell phone number (for internal UA records)
Your answer
Would you like to be added to our State and Higher Ed Issues Committee list to be contacted when there is a time-sensitive legislative action? (e.g. a request to contact city or state legislators on a particular issue)
Yes (if yes, please write in below your preferred method of contact, email or text)
No
Other:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of AFT Vermont.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report
