Wufoo

Fight for Pay Equity Survey

With your help, we can work to end wage silence and create radical transparency around pay and working conditions in the news/media, nonprofit, and tech sectors.

The information for the database is being collected by and for workers like you. No personally identifying information will be published as part of this project, and the published analysis will ensure individuals cannot be identified. You have the option to answer anonymously or to provide contact information for follow-up by CWA staff and updates on the project, but in neither case will we share your identity publicly.

Note: * means question is required

Gender *
Woman Man Transgender/Trans Woman Transgender/Trans Man Genderqueer/Non-Binary Prefer Not to Say Not Listed
Age (leave blank if you prefer not to answer)
Please only enter numbers, not text.
Level of Education (Select highest level completed) *
High School Some college Bachelor’s degree Master’s degree Ph.D Certificate
Race/Ethnicity (Check all that apply) *
Black White Asian/Pacific Islander Native American Latino Some other race
Do you have a recognized disability? *
Yes No Not sure
City of employer *
State of employer. *
Do you work remotely? *
Yes, some of the time Yes, all of the time No, none of the time
In which industry do you work? *
Nonprofit Media Tech
What is your job title? *
Provide a brief description of your job duties. *
Name of current employer (Optional)
Do you work part-time or full-time? *
Full-time Part-time
Are you paid on an hourly basis or on a salaried basis? *
Hourly Rate Salary
What is your hourly rate of pay?
Please only enter numbers, not text.
What is your yearly salary?
Please only enter numbers, not text.
Is your pay based on a 40-hour work week?
Yes No
How many hours per week do you work on average?
Please only enter numbers, not text.
What percentage of hours worked, if any, are uncompensated?
Please only enter numbers, not text.
Do you receive overtime pay
Yes No
How many hours do you work per week on average?
Please only enter numbers, not text.
How many hours of work per week, if any, are uncompensated?
Please only enter numbers, not text.
Do you receive any additional compensation, such as incentive pay or bonus pay?
Yes No
What is the approximate total of that additional compensation over the past year?
Please only enter numbers, not text.
Are you a permanent employee, a temporary employee, or a contractor? *
Permanent Employee Temporary Employee Contractor
How many years have you worked for this employer?
Please only enter numbers, not text. *
How many years have you worked in this industry?
Please only enter numbers, not text. *
Have you ever negotiated for better compensation such as higher pay?
Yes No
Provide a brief description of your experience.
How many different employers in this field/industry have you worked for in the last
five years?
Is the job you are currently in unionized? *
Yes No Unsure
What is the name of your union?
Thank you for taking the time to complete this survey! Can you take the time to answer a few additional questions?
Yes No thanks
Do you believe you have experienced or witnessed discrimination, prejudice or inequity in your job?
Yes No
Please explain.
Do you believe your supervisor/manager/employer has discriminated against you on the basis of any of the following characteristics? (Select all that apply.)
Age Disability Race/Ethnicity National Origin Gender I Sexual Orientation Religion Pregnancy Arrest/Conviction Record None of the above Other
If you have experienced or witnessed prejudice or discrimination at your place of employment, please describe the way(s) in which you believe you or your coworkers were treated.
What are your main concerns about your job?
Are you satisfied with the amount of time you work and the amount of time you devote to your personal life?
Yes No
Have there been any changes in your work/life balance in the past 5 years?
Yes No
If you have experienced a change in work/life balance, check the appropriate answer below that describes your situation.
Improved significantly Improved slightly Remained the same (neither improved not deteriorated) Deteriorated slightly Deteriorated significantly
Has a supervisor or any employer representative ever suggested that there would be negative consequences for you or your coworkers if you formed a union?
Yes No
Please explain
Has a supervisor or any employer representative ever questioned you or your coworkers about union activity?
Yes No
Please explain
Has a supervisor or any employer representative required that you attend a
meeting/meetings to discuss potential impacts of unionizing (captive audience
meetings)
Yes No
Please explain
How can we get in touch? (Optional)

You have the option to answer anonymously or to provide contact information for follow-up by CWA staff and updates on the project, but in neither case will we share your identity publicly.
Name First Last
Zip Code
Personal Phone Number ### - ### - ####
Personal Email
CWA
501 3rd Street NW
Washington, DC 20001
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