AZ Federal Mandate Worker Survey
County & Municipal governments and businesses in Arizona are starting to announce COVID vaccine requirements in anticipation of the Federal Mandate. Many Arizona workers oppose a mandate and are now at risk of losing their jobs and their retirement.

There are about 200,000 government employees and hundreds of thousands more impacted through private employers who have contracts with the Federal government.

If you are a worker in Arizona (or retired), whether public or private sector, and you stand against mandates, we need your help! Please help protect Arizona workers and stand with us by completing the survey below.

YOUR CONTACT INFORMATION IS OPTIONAL.

Thank you so much for taking a stand and fighting for our state! You are our heroes and we will peacefully fight to save our state! From the bottom of our hearts, thank you for your service!
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First Name
Last Name
Email
Cell Phone Number
City of Residence *
Are you retired, past, or a current government employee? *
Required
Who is the employer you reference in the question above? *
Has the employer announced a mandate? *
What is (or was) your industry? *
Please list your occupation. *
If you are a member of a union or association, please list it below. *
What department do you or did you work in? *
QUESTIONS FOR WORKERS FACING A MANDATE
How likely are you to submit an application for an exemption to the vax mandate?
Not Happenning
Highly Likely
Clear selection
If you submitted an application for accommodation, would it be religious or medical?
Clear selection
If your application for accommodation is denied, how likely are you to comply with the mandate?
I will not comply
Compliance Highly Likely
Clear selection
How confident are you that your answer to the previous question will not change?
Very Low Confidence
Highly Confident It Will Not Change
Clear selection
What support do you need to shore up your determination to stand your ground? You can also send a private Telegram message to Ms. Hamilton with additional concerns. @merissa_hamilton
ACTION OPPORTUNITIES
ORGANIZE. Do you plan to attend the Arizona Heroes Workers Freedom March on Dec. 7th? *
ORGANIZE. Are you in our Freedom telegram group? If not, would you like to be added? To be added, you must list your Telegram ID below.
Clear selection
Telegram ID
PUBLIC COMMENT. Will you help us with Public Comment at the City Council meetings between now and Dec. 7th? We can train you.
DISRUPTION. Can you help us collect signatures for the Scottsdale School District Recall effort? A successful recall is vital in disrupting the political class. We need 300 more volunteers for this effort. Sign up at ParentsPushBack.com. *
RECRUITMENT. Can you help us recruit other impacted employees or workers from across the state in public and private sectors impacted by the Federal mandate? This requires access to a computer, smart phone, and light knowledge of using excel or google sheets. We will train you.
Clear selection
VOTER OUTREACH. Can you help us with outreach to voters via texting? This requires access to a smart phone and downloading the app called SA Group TXT. We can train you.
Clear selection
VOTER OUTREACH. Can you help us with outreach to voters via door flyers and/or door knocking? We can train you.
Clear selection
EVENTS. Would you like to help us with organizing the events on Dec. 7 or other events around the city to promote our cause?
Clear selection
POLICY. Would you like to be considered to speak or attend a private Arizona Legislative Committee meeting with Arizona workers facing the federal vax mandate threats during lunch time on December 7th? Please note the time may change, but it is scheduled for 11 am at the moment.
Clear selection
MESSAGE. Do you want to participate in press conferences or other media activities?
Clear selection
MESSAGE. If we can raise the funding, can you help us deliver and install yard signs?
Clear selection
EFFECTIVENESS. Would you like to attend a civic action or civic education training program to learn more on how to take effective action? Classes can be online or in person. Email address is required above.
Clear selection
SUBSCRIBE. Would you like to stay in touch on this issue and be added to the EZAZ.org email/txt list? Email address and/or cell phone above is required above. *
Required
Thank you for taking the time to complete this survey and for your courage! If you have any questions, please feel free to reach out to Merissa at 480-374-0102.
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