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* 1. If JHRC sponsored a community discussion on an issue of concern to you and your family, which topic would most interest you?

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* 2. What topics would you most like to learn about or discuss at this event?

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* 3. What type of discussion would you be most likely to attend or participate in?

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* 4. Please select your age range:

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* 5. Please select your gender:

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* 6. Please indicate your home zip code:

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* 7. To which racial or ethnic group(s) do you most identify?

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* 8. To which faith group(s) do you identify?

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