Atelier sur les changements climatiques - Formulaire de commentaires

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NAME OF PERSON COMPLETING THIS FORM

CUPE LOCAL NUMBER

YOUR ROLE IN YOUR LOCAL, IF ANY (E.G. SHOP STEWARD, RECORDING SECRETARY)

YOUR EMAIL ADDRESS

BEST PHONE NUMBER TO REACH YOU AT

Cell

Work

Home

NAME OF YOUR EMPLOYER

WORKPLACE

CITY/TOWN

PROVINCE

ARE YOU THE PERSON WHO HOSTED THE WORKSHOP?

Yes

DATE OF WORKSHOP

HOW MANY PEOPLE TOOK PART?

DID ANYONE COME WHO WAS NOT A CUPE MEMBER? IF SO, WHO?

BASED ON YOUR DISCUSSIONS, WHAT ISSUES ARE THE MOST IMPORTANT FOR YOUR CUPE LOCAL OR COMMUNITY (LIST ALL)?

ARE THERE ANY CLIMATE CHANGE THREATS IN YOUR COMMUNITY (PLEASE PROVIDE DETAILS)?

WHAT ACTIONS DO PARTICIPANTS PLAN TO TAKE?

WHAT SUPPORT DO YOU NEED FROM CUPE TO TAKE ACTION?

DO YOU HAVE ANY OTHER FEEDBACK FOR US?

Atelier sur les changements climatiques - Formulaire de commentaires

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