Please fill this survey out, so that we can find the best match for a One Small Step conversation. 

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* 1. Contact Information

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* 2. Primary language spoken?

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* 3. How did you hear about One Small Step?

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* 4. Preferred method of contact

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* 5. Best time to contact you? (Please specify hours, a.m or p.m.)

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* 6. Anytime that we should not contact you?

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* 7. What is your age?

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* 8. What is your gender?

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* 9. What is your current religion, if any?

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* 10. Which race/ethnicity best describes you? (Please choose only one.)

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* 11. Which of the following best describes your current occupation?

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* 12. Do you consider yourself a ...

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* 13. When you consider your political thinking, which of the following best describes you?

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* 14. Please describe your ideal partner for this conversation (in terms of political ideology, beliefs, etc.)

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* 15. What do you want to achieve by participating in a conversation with someone who holds a different political viewpoint? (please explain in no more than 3 sentences)

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* 16. Do you have any concerns about participating in a conversation with someone who holds different political views than your own? (please explain in no more than 3 sentences)

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* 17. What time of day is best for you to participate?

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* 18. Please describe youself, including any details you think a potential conversation partner should know about you. If you are chosen, this short bio will be shared with your conversation partner prior to your discussion together. 

0 of 18 answered
 

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