PA New Member Survey

MVCC Professional Association

PA Member Survey

The MVCC Professional Association strives to make positive connections between our union and our community.

Your survey responses will help us to understand how our members are already involved in community activities and will provide direction for future community outreach by the Professional Association.

For completing this survey, you will receive a new blue polo shirt bearing the PA logo.

If you have any questions about the survey, please contact Norma Chrisman at extension 5398 or nchrisman@mvcc.edu .

I. Identification Information

1) Name
2) Department/Area
3) Position
4) Highest Degree
5) Year that you came to MVCC:
6) Desired size for your PA polo shirt:	Men (S M L XL 2XL, 3XL, 4XL, 5XL):

II. Professional Memberships

Are you a member of a professional organization, such as the Modern Language Association, American Society of Criminology, Human Anatomy & Physiology Society, American Nurses Organization, Phi Delta Kappa, Justice Studies Association, American Society of Civil Engineers? If so, please provide the full name of each organization:

1)
2)
3)
4)
5)

III. Community Involvement

Indicate your affiliation with community organizations in the categories below as well as the role in which you serve--that is, as an officer/leader of the group or as a member/participant.

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Human Services			Health-Related Associations
		YWCA/YMCA			American Red Cross
		United Way			American Cancer Society
		Insight House			American Lung Association
		UCP			American Heart Association
		ARC			MS Association
		Habitat for Humanity			Cystic Fibrosis Association
		Hospice			Diabetes Association
		Hope House
		Hall House
		Thea Bowman House
		RCIL
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Community Events			Education Related
		Boilermaker			local school boards
		Walk for Life			libraries
		Heart Run & Walk			parent-teacher organizations
		Making Strides for Breast Cancer			Learning Disabilities Association
					Literacy Volunteers
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Regional Promotion/ Economic Development			Political Organizations/ Human Rights
		Chamber of Commerce			Democratic Party
		Visitors Bureau			Republican Party
		Mohawk Valley EDGE			Amnesty International
		Leadership MV			NAACP
		Workforce Investment			League of Women Voters
					elected office(s)
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Arts & Historical			Religiously-Affiliated Organizations
		Community Arts Council			Salvation Army
		Kirkland Arts			Rescue Mission
		Rome Arts Center			individual groups/ communities of worship such as church, synagogue, etc.
		Players of Utica
		historical societies
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Service Clubs			Animal & Environment
		ZONTA			Humane Society
		AAUW			Spring Farm CARES
		Optimists			Sierra Club
		Rotary			Utica Marsh Council
		Kiwanis			Utica Zoo
		Moose/Elks			Adirondack Mountain Club (ADK)
		Sons of Italy
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Youth Clubs			Athletic Groups/Clubs
		Boys & Girls Club			running
		Big Brother/Sister			skiing
		Girl/Boy Scouts			golfing
		AYSO			hiking
		Little League			bowling
		Pop Warner			curling
		Kidz-N-Coaches			biking
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Military/Veteran			Fire, Rescue, Medical
		VFW			volunteer fire departments
		American Legion			COCVAC
		Reserves			ski patrol
Other:			Other:
Other:			Other:

officer/ leader	member/ particip't	Organization/ Event	officer/ leader	member/ particip't	Organization/ Event
Collecting & Hobbies			Other
		scrapbooking
		coins
		stamps
		quilting
		toy trains
		photography
Other:
Other:

VI. PA Community Involvement

Indicate your interest in the following current PA activities.

I would like to parti- cipate	CURRENT PA Activities		I would like to parti- cipate	CURRENT PA Activities
	PA scholarship			PAnorama
	Ted Moore Run/Walk			website (mvccpa.org)
	Heart Run & Walk			VOTE/COPE
	Thea Bowman Bowling			Annual Fall Picnic
	Making Strides Breast Cancer			Annual Spring Luncheon
	curling			Educators Meet Legislators
	food drives			CNY Labor Council
	holiday fundraiser			NYSUT phone banks
	Foundation golf tournament			sunshine club
	basketball reception for legislators

If the PA sponsored any of the following activities, would you be interested in participating?

Yes	No	POSSIBLE FUTURE PA Activities		Yes	No	POSSIBLE FUTURE PA Activities
		labor movie night				pizza party
		holiday party				coffee hour
		bowling events				golf outing
		Labor Day parade				student outreach
		bus trips (to theater, ball games, shopping, other activities)				social hour at local restaurant

Thank you for completing the PA membership survey!
Your feedback will help us all work together to build a more effective union to benefit YOU.

When you click submit, you will see a "success" page that confirms the submission of your survey.
Your order for your new blue PA polo shirt will be processed within a few weeks.