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I need sick pay due to the COVID-19 crisis! Necesito pago de enfermedad basado en el crisis de COVID-19!
We won 80 hours paid sick leave, plus ten weeks of paid family and medical leave at small to medium-sized employers. The information you provide here will be sent to a CTUL organizer who will contact you with more information and resources about how to organize to receive these benefits.
Ganamos 80 horas de dias de enfermedad pagados mas 10 semanas de ausencia medica pagada en empleadores de tamano pequeno a mediano. La informacion que entres en este formulario se mandara a un organizador de CTUL quien te contacara con mas informacion y recursos de como organizar para recibir estos beneficios.
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* Indicates required question
Email
*
Your email
Name / Nombre
*
Your answer
Phone Number / Numero de Telefono
*
Your answer
Employer Name / Nombre del Empleador
*
Your answer
Workplace Location / Ubicacion del Trabajo
*
Your answer
How many employees does your employer have? / Cuantos empleados tiene tu empleador?
*
1-5
5-20
20-50
50-100
100-500
Other:
Industry / Industria
*
Food Service (restaurant, fast food, cafeteria, etc) / Servicio de Comida (restaurante, comida rapida, cafeteria)
Cleaning or Hotel / Trabajo de Limpieza o Hotel
Healthcare (hospital, nursing home, PCA, etc) / Cuidado Medico (hospital, asilo de ancianos, asistente de salud personal)
Retail (store, supermarket, shop, etc) / Tiendas (todo tipo de tienda: grande, pequeno)
Construction / Construccion
Transportation and Logistics (warehouse, truck driver, bus driver, etc) / Transporte y Logistica (bodega, trailero, chofer de autobus, etc)
Education (K-12, day care, etc) / Educacion (K-12, cuidado de ninos, etc)
Gig Economy/Freelance / Contratista Independiente
Other:
Workplace Issues related to COVID-19 / Problemas en el Trabajo relacionados con COVID-19
*
Lost Hours / Perdi horas
Job shut down / Cerro mi trabajo
Have to take care of kids at home and not getting paid /Tengo que cuidar mis ninos en la casa y no estoy recibiendo pago
Inadequate Safety Equipment / No suficiente equipo de preteccion
Wage Theft (not paid all hours worked) / Robo de Salario (no fui pagado todos mis horas trabajadas)
I need to self-quartantine for safety reasons and I am not getting paid / Necesito estar en cuarentena para razones de seguridad y no me estan pagando
I need to take care of a sick family member / Tengo que cuidar un familar que esta enfermo
Other:
Required
Are your co-workers in a similar situation? / Tus companeros de trabajo estan en una situacion similar?
*
Yes / Si
No
I don't know / No se
Anything else you want to tell us at CTUL? / Algo mas que quieres decirnos?
Your answer
A copy of your responses will be emailed to the address you provided.
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