Survey

The Economic Justice Coalition strives to assist residents in and surrounding Athens-Clarke County in obtaining a living wage. This survey is to determine the need for assistance in obtaining a living wage. Please complete the survey and leave it at the office or return the survey to the facilitator.	Yes No
1. Are you currently employed? If no, go to questions 3. *	Yes No
2. What type of work do you do? *
3. If not employed, when was the last time you had a job? *
4. Do you have more than one job? *	Yes No
5. What is your current salary or how much did you earn an hour on your last job? If you have only one job, go to question 7.	True False
Less than $6.75 per hour	Yes No
$6.75 per hour	Yes No
$6.76 - $7.75 per hour	Yes No
$7.76 - $8.75 per hour	Yes No
$8.75 - $9.99per hour	Yes No
$10 or more	Yes No
6. How much do you earn an hour on your second job? *
7. How do you look for a job?	True False
Surf the Internet * Read the want ads * Go to the unemployment office * Go to a temp agency * Word of mouth/referral * Other *
8. Do you have access to the Internet? *	Yes No
9. What are your job skills? *
10. What is the highest level of school you have completed? *
11. Please print the complete name of the high school you attended. *
12. Would you like to further your education? *	Yes No
13. What would prevent you from furthering your education? *
14. Have you had any training on how to interview for a job? *
15. What is your living arrangement?	True False
Pick one: Live alone * Live with one or both parent * Live with friend(s) * Live with children * Live with sister(s) and/or brother(s) *
16. Please identify the transportation used to get to this office?	True False
Pick one: Personal vehicle * The Bus * Cab/Taxi * Walk *
17. Please indicate what time you went to bed last night. *
18. Tell me about the best supervisor you ever had on the job. Why were they the best supervisor? *
19. Which of these jobs require a high school diploma or GED?	True False
CNA Newcare CenterNewcare is seeking FT community Support Coordinator needed to coordinate services for people with disabilities, supervise staff and manage emergency and backup system. College degree in related human services required. This is a position with health and dental benefits. Experience in supported living and supervision is required. Email cover letter and resume hr.newcarecenter.org *	Yes No
Salesperson Look Good Shoe Co.Seeks FT or PT retail shoe salesperson; Retail experience preferred. Salary VS commission; no night work; and no Sundays; paid vacation and employee discount. Mail your resume to: Salesperson, P O Box 888, Athens GA 30600. *	Yes No
Accounting Clerk I Local company has an immediate opening for a Clerk I accounting position. Bachelor degree in accounting or related field preferred; excellent benefit package; Duties include inventory management, AP and general ledger. Send resume to Human Resources, P O Box 999, Athens GA 30600. *	Yes No
20. How many of these jobs ask the applicant to make contact by mail? (Use the above jobs) *
How many of these jobs ask the applicant to make contact by the Internet? *
21. Which of these jobs provide health insurance? *
22. How did you learn about Economic Justice Coalition?	Yes No
Word of mouth * Referral * Brochure/Flyer * Event * Other *
23. Which of Economic Justice Coalition services have you used?	True False
Food Bank * Job Search * Employee Rights * Unity in the Community *
24. Do you have children? If no, go to question 26. *	Yes No
25. What are your children ages? *
26. Gender: Female * Male *
27. Marital Status: Married * Single * Separated * Divorced *
28. Age: Less than 20 * 21 – 25 * 26 – 30 * 31 - 40 * 41 – 50 * More than 50 *
29. Additional Comments: *
30. About You: (Optional)	True False
Name *
email *
Address *
Phone *
City/State/Zip