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BTU COVID-19 Vaccine Survey
All personal information will be kept confidential. We collect names and employee IDs to verify membership and ensure there are no multiple votes. Specific school level data will also not be shared with the district.
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* Indicates required question
First name
*
Your answer
Second name
*
Your answer
Employee ID
*
Your answer
BTU Chapter
*
PSRP
Teacher
I have already received the first shot of the vaccine.
*
Yes
No
I have already received the second shot of the vaccine.
*
Yes
No
I plan to get the vaccine as soon as I can.
*
Yes
No
Maybe
I would be willing to teach in-person BEFORE receiving a vaccine.
*
Yes
No
Maybe
I would be willing to teach in-person ten days AFTER receiving the FIRST shot of the vaccine.
*
Yes
No
Maybe
I would be willing to teach in-person ten days AFTER receiving the SECOND shot of the vaccine.
*
Yes
No
Maybe
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