CWA
Local 7803


Communications Workers of America




















Dex Media Form

Local 7803 is gathering updated information (similar to the survey conducted recently) to protect the interest of our represented employees working for Dex Media.  All the information collected will be compiled into a total per office. All information will be held in the strictest confidence.

We are requesting this information be current and accurate as of the latest paycheck and pay period close.  We are requesting that all employees provide the information to the best of their knowledge.  We realize that specific numbers may be difficult to provide but please do your best to estimate the information if you do not have exact data.

We are also asking that you take this survey TODAY.  We need to have the survey completed by Saturday, May 30th.  It should take approximately 2-3 minutes to fill out.

Please encourage any co-workers you know to check their email, and complete this form as well.  

Thank you in advance for your support and participation!



* Required Fields
Name: (first, last) *
Contact phone number: (home or cell) *
Home email address: (not Dex related)
Office: *
Job Title: *
Term of Employment date (TOE/Hire date): *
Number of vacation days allowed for 2009 *
Number of vacation days still remaining (unused) for 2009 *
Number of personal days allowed for 2009 *
Number of personal days still remaining (unused) for 2009 *
What is your average daily commission? *
Current 401K contribution rate: *
Please describe any other payments still owed to you: (please include dates, amounts and details)


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