Name of workplace:
Name of department (if applicable):
Address of workplace:
Type of Workplace
Business
School
Other
Approximate number of employees:
*
Select
Up to 10 employees
Up to 100 employees
100 employees and up
Type of workers in the company
*
Select
All the workers are frum
Most of the workers are frum
Most of the workers are not frum
Is there is a filter on the network?
*
Select
Yes
No
Name of filter:
Do you need to log into a computer that is not filtered?
*
Select
Yes
No
If there is no filter on the network, may a filter be installed on a specific work device?
*
Select
No
Smartphone
Tablet
Other
Can this device be filtered?
*
Select
No
Smartphone
Tablet
Other
Will an employee be required to have an additional device?
*
Select
No
Smartphone
Tablet
Other
Can this device be filtered?
*
Select
No
Smartphone
Tablet
Other
Is internet access required at home after hours?
*
Select
YES
NO
Is social media usage required?
*
Select
YES
NO
What form of communication is used between colleagues and/or customers (i.e. messaging, whatsapp, slack etc.)
INTERACTION BETWEEN MEN/WOMEN
Are women addressed on a first name basis with men?
*
Select
Yes
No
Do women take on a “work” name which men address her by?
*
Select
Yes
No
Are female employees seated separately?
*
Select
In a separate room
Separate seating in a shared space
No possibility
Does a locked door prevent others from entering while male employees are present?
*
Select
YES
NO
Is there an option for separate seating for frum employees?
*
Select
In a separate room
Separate seating in a shared space
No possibility
NA
Are there separate facilities for men and women (kitchenettes/coffee stations etc.)
*
Select
Yes
No
NA
Are employees required to participate in social events with all employees (ex: lunches/parties/team events)?
*
Select
YES
NO
NA
What is your source of information for answering these questions?
*
Select
I work for the company
From my work interview
Another source
Contact information (optional: if you have any questions/comments)
Comments:
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For any questions, call 908-MEYDAIM (908-639-3246)
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