Your First Name
Your Last Name
Enter the information for the individual you had a one-to-one conversation with.
Format of Conversation (select one) Note: E-mails are not considered a 1-to-1.
1:1 Video Call
Small Group In-Person
Small Group Video
If Other Type of Conversation, Please Explain
What part of the conversation stood out to you?
What issue(s) did this person identify in this conversation?
Would you describe this person as a natural leader?
Who did this person identify as a natural leader? (Please use the most accurate spelling possible.)
Who did this person identify as a second natural leader? (Please use the most accurate spelling possible.)
Assessment of Membership (select one):
Plans on Joining
Undecided on Membership
Leader and/or Activist Potential (must be a member)
Anti-Union/Will Not Become Member
If haven't joined our Association yet, what is holding them back?
What is your follow-up plan with this person?