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Your participation in this survey will remain completely anonymous.

Thank you for your time.

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* 1. Age:

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* 2. Are you a resident of Oak Lawn?

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* 3. Gender:

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* 4. What is your race/ethnicity?

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* 5. Name of School (if applicable):

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* 6. Do you ever feel as though the Oak Lawn community does not accept you due to your race and/or ethnicity?

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* 7. How often do you feel you encounter discrimination in the Oak Lawn community?

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* 8. If you are, or have ever been, a student in Oak Lawn, did you ever experience discrimination?

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* 9. If you did experience discrimination as a student in Oak Lawn, by whom? (check all that apply)

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* 10. Which school did you attend in Oak Lawn?

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* 11. Do you work in Oak Lawn?

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* 12. If you answered "Yes" to question 11, have you ever experienced discrimination at work?

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* 13. I have experienced discrimination by my neighbors.

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* 14. I have experienced discrimination by the Oak Lawn Police Department.

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* 15. I have experienced discrimination at the following places (check all that apply):

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* 16. If you have ever experienced discrimination, what kind was it? (check all that apply):

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* 17. I have experienced discrimination in another aspect.

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* 18. Have you ever personally witnessed an act of discrimination against another person in Oak Lawn?

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