JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
GEO Unsafe Working Conditions Form
Please complete this form so that the GEO Grievance Committee can know your experiences related to unsafe COVID-19 working conditions.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
1) Name
*
Your answer
2) Net ID
*
Your answer
3) Pronouns (if you want to share)
Your answer
4) Non Illinois email address
*
Your answer
5) Phone number (so we can follow up with you)
Your answer
6) Department
*
Your answer
7) Working Department (if different to #5)
Your answer
8) What is your modality of work currently?
*
Online
In person
Hybrid
Other:
Required
9) Please write a testimonial describing your experience related to unsafe COVID-19 working conditions.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Graduate Employees' Organization.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report