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DNT Focus Group Submission Form

Instructions

In the first section answer the questions about yourself .

In section two name the people pictured in each photograph. If you don't recognize someone at all respond with "I don't know."

Please complete this survey on your own and without the assistance of the internet.
Section 1: Questionnaire
1.Full Name:(Required.)
2.Email:(Required.)
3.Phone#:(Required.)
4.Gender:(Required.)
5.Age:(Required.)
6.What is the highest level of school you have completed or the highest degree you have received?(Required.)
7.What city and state are you based out of?(Required.)
8.If selected to participate, this focus group will be held in Los Angeles, CA. All travel and expenses will be covered if traveling. Would you be willing to join the focus group IN PERSON and travel if applicable?(Required.)
9.Which of the following best describes your political values?(Required.)
10.Are you affiliated with any progressive political organizations?(Required.)
11.What is your stance on the Israel/Palestine conflict? (Select the option that best reflects your view)(Required.)
12.What is your stance on cultural appropriation?(Required.)
13.What is your stance on U.S. immigration policy? (Select the statement that best matches your beliefs)(Required.)
14.Have you ever participated in a form of direct action (ie boycotts, strikes, protests for a cause etc.)?(Required.)
Section 2: Prominent People
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