Grant Application for
Women Organizers

1. Your Name

First name:    Middle initial:   

Last name:

2. Union or organization:

Local number, if any:

3. Position in local or organization:

4. Email address:  

5. Phone number: Area code:   Number:   Ext:

Fax number:

6. Cell phone: Area code:   Number:

7. Address: Street address:

City:    State: Choose: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY    Zip:

8. Currently employed?    Yes    No

9. If yes, name of employer:

10. Weekly wage: $

11.Have you attended the organizing institute (OI)?     Yes    No   
If yes, date:

12. Have you ever worked on an organizing campaign?      Yes    No   

If yes, list 1 - 3 recent campaigns and outcomes:

13.Were you the lead organizer?      Yes    No   

Part II: Organizing Target Profile

1. Name of employer:

2. Number of workers:

3. Type of work done by workers:

4. Hours of work (night, day etc):

5. Major job titles:

6.Describe make up of group: (% men, women, minorities)

7. Do workers speak language other than English? Note language and %

Part III: Organizing Campaign

  1. How much contact have you had with this group? (Click where appropriate)

Talked to 1 - 2 workers a few times
Talked to over 10 workers on at least 4 occasions
Have strong connection to workers through family members, former union members etc (explain)
Have not made direct contact with any worker yet

2. In what stage is the organizing campaign? (Click where appropriate)

Stage 0: A target has been identified. You have spoken to 1-2 workers
Stage 1: You have met with workers. At least 10% of workers have been contacted about the union by
an organizer or by fellow workers. You have a clear sense of the top workplace issues.
Stage 2: You have recruited an inside organizing committee. There should be one committee member
for every 10 workers. All types of jobs and shifts should be represented on committee. Also the
committee should reflect the gender, race make up of the group. The committee has been working
together on campaign or is ready to begin work.
Stage 3: The committee is ready to go public. Ready to start signing up workers supporting the union.
Committee must contact workers one on one to get signatures.

3. If you receive this grant what is your goal for this campaign for next 3-4 months? (explain plan)

4. Is there an experienced organizer who would advise and help you on this campaign?
     Yes    No
If yes, provide Name, Union, position:

Date:

Part IV:

1. Name of Local President/Principal Officer:

2. Union/Local:

The above-mentioned officer supports this organizing drive and recommends that you receive a grant from the Berger-Marks Foundation.

If the organizing drive is successful workers will either (click one):
       Join the above local
      Form their own local union

Best phone number to contact Local President/Principal Officer:

Email address:

Make sure you've filled out all the above fields and printed a copy for your records.

Then:

(Hitting this button submits your application to the Berger-Marks Foundation)