Worker Survey during Hurricane Michael

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Central Florida Jobs with Justice set up a survey for working people in Florida to fill out on what they are facing with their employers while dealing with Hurricane Michael. This survey is meant to help us on how best to support our communities pre and post storm, assess community needs, and communicate with government officials. Your responses are confidential and will not be released without your consent first.

If you have questions or need follow up, please call our direct voicemail line at 407-920-8927 and our goal is to respond to calls within 72 hours. We are monitoring the line throughout the storm and how best to re- direct people in need and resources once the storm passes.

Central Florida Jobs with Justice (CF-JwJ) is a non-profit coalition that advocates for workers and their communities. It is a coalition made up of community organizations, faith based groups, labor unions, and student groups advocating for stronger worker protections and rights.

DISCLAIMER: Please understand that CF-JwJ is not offering, nor should filing out this survey be understood to provide legal services or assistance with regard to employment.

First and Last Name

County and Zip Code where you live *

Phone Number where you can be reached

Job Sector or name of employer *

Your job position or occupation

I am a *

Salaried Employee

Hourly employee

Tipped or Commissioned employee

Temporary or sub contracted worker

Other:

Check if you experience any of the following situations on the job: *

Threaten or right out fired for not coming to work leading up to /during the hurricane

Not given adequate time off to prepare for the hurricane

Scheduled to come to work leading up to/ during the hurricane

Forced to be on call/ stay on the job without getting paid

Told to report to work after an evacuation/curfew order

Felt my employer put me in imminent danger of the storm while on the job

Forced to fill a emergency/essential position even though you fill a non-essential position

None of the Above

Other:

Required

Check if you experience any of the following job complications due to the hurricane: *

Unable to get childcare because of school/childcare closings

Unable to get to work because of reliable public transportation/road closings

Loss of hours/wages due to job closure

Unemployed as a direct result of the disaster

Unable to afford food/supplies/gas or any costs associated with preparing for hurricane

Went to work while experiencing a power outage or damage to your home.

None of the above.

Other:

Required

Check all that apply :

I would like more information about my rights as a worker and be contacted about my experience

I would like to stay involved and volunteers with relief efforts/donations for workers after storm.

I would like to connect to social services/ community resources available

I would like to learn about forming a Disaster Resilience and Readiness group in my community.

Other:

Additional comments or information you would like to share ...

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Central Florida Jobs with Justice.

Does this form look suspicious? Report

Forms