EXIT BUILD Membership Survey Welcome! Thank you for your interest in BUILD. Please take a few minutes to complete this membership survey. Your information will help us strengthen our communication, meetings and events. Thank you! OK Question Title * 1. How did you hear about BUILD? Check all that apply Co-worker Friend Email BUILD Website Another website Facebook BUILD member If a BUILD member referred you, what is their name? OK Question Title * 2. What is your... Preferred first and last name Email Address Phone Number OK Question Title * 3. Have you attended one or more meetings in the past 6 months? Yes No OK Question Title * 4. Have you received a welcome email/phone call from the BUILD welcoming committee? Yes No OK Question Title * 5. What meetings have you attended? Check all that apply 1/16/20 – Business meeting, subcommittee report out, and storyteller Edwina Martin-Arnold 2/21/20 – Black History Month Celebration 4/16/20 – Financial Security and the Black Community, key note speaker Mikia Guy 5/21/20 – Mental Health and the Black Community, key note speaker Cindy Guertin-Anderson 6/18/20 - Juneteenth Meeting, Governor Q&A, key note speaker Dr. Karen Johnson 7/16/20 - Health & Wellness with Edwina Martin-Arnold and OneWA interview with Vann Smiley OK Question Title * 6. What agency do you work for? Archaeology and Historic Pres Bd of Reg Prof Eng Land Surv Board for Volunteer Firefighte Board of Industry Ins Appeals Board of Pilotage Commissioner Board of Tax Appeals Caseload Forecast Council Columbia River Gorge Comm. Com Asian-Pacific Amer Affairs Commission on Judicial Conduct Consolidated Technology Svcs County Rd Administration Board Court of Appeals Deaf and Hard of Hearing Youth Department of Agriculture Department of Commerce Department of Corrections Department of Ecology Department of Fish & Wildlife Department of Health Department of Licensing Department of Transportation Department of Veterans Affairs Dept of Child Youth & Families Dept of Enterprise Services Dept of Financial Institutions Dept of Labor & Industries Dept of Retirement Systems Dept of Revenue Dept of Services for the Blind Dept of Social & Health Serv. Dept. of Natural Resources East Wa St Historical Society Econ and Revenue Forecast council Employment Security Department Environmental & Land Use Heari Freight Mobility Strategic Inv Gov. Office of Indian Affairs Health Care Facilities Auth. Higher Education Institutions House of Representatives Human Rights Commission Joint Leg Audit and review Com Joint Leg Systems Committee Joint Transportation Comm Leg Eval & Account Prog Comm Leoff Plan 2 Retirement Board Liquor and Cannabis Board Military Department Ofc of Minority & Women's Bus Off of Administrative Hearings Off of Insurance Commissioner Off. Administrator Courts Office of Civil Legal Aid Office of Financial Management Office of Leg Support Services Office of Public Defense Office of State Actuary Office of State Auditor Office of State Treasurer Office of the Attorney General Office of the Governor Office of the Lieutenant Gov Office of The Secretary of St Public Disclosure Commission Public Employment Relations Co Puget Sound Partnership Recreation and Conservation State Board of Accountancy State Conservation Commission State Health Care Authority State Investment Board State Law Library State Lottery Commission State Parks & Recreation Comm State School for the Blind State Senate Statute Law Committee Student Achievement Council Supreme Court Supt. of Public Instruction Tabacco Settlement Authority Transportation Commission Transportation Improvement Bd. Utilities & Transportation Com WA Citizen's comm on salaries WA ECON DEV FINANCE AUTH WA Horse Racing Commission WA Pollution Liab Ins Program Wa St Comm African-American Af WA St Comm on Hispanic Affairs Wa St Criminal Justice Train C WA State Housing Finance comm Wa Traffic Safety Commission Wa. St. Historical Society Washington State Arts Comm. Washington State Gambling Comm Washington State Patrol Work Force Train & Ed. Cor Bd. If you work in the private sector, please enter your business name here: OK Question Title * 7. My gender is Female Male Non-binary Other (please specify) OK Question Title * 8. I identify as... (check all that apply) Black or African American Indian and Alaska Native Asian Hispanic, Latino or Spanish Origin Native Hawaiian and Other Pacific Islander White Prefer not to say Prefer to identify as OK Question Title * 9. Are you serving or have you served in the military? Yes No OK Question Title * 10. What county do you work in? Adams Asotin Benton Chelan Clallam Clark Columbia Cowlitz Douglas Ferry Franklin Garfield Grant Grays Harbor Island Jefferson King Kitsap Kittitas Klickitat Lewis Lincoln Mason Okanogan Pacific Pend Oreille Pierce San Juan Skagit Skamania Snohomish Spokane Stevens Thurston Wahkiakum Walla Walla Whatcom Whitman Yakima OK Question Title * 11. We sometimes serve food at our events, do you have any food allergies? Check all that apply No allergies Cow's Milk Eggs Tree Nuts Peanuts Shellfish Wheat Soy Fish Other (please specify) OK Question Title * 12. Will you need any accommodations for meetings or events? Yes No OK Question Title * 13. What sub-committee(s) are you interested in? History and Activities Marketing and Data Membership Engagement and Support Policy and Legislation Professional Development and Leadership Support None at this time OK Question Title * 14. What is your hope in being a part of BUILD? Check all that apply. Build and strengthen relationships with others To be an ally Learn more about black history Further understanding racial and social justice Strengthen professional development and leadership skills Learn and be an advocate for policies affecting the black community Be a mentor/mentee Be able to talk about race at work Other (please specify) OK Question Title * 15. What types of social media do you use? Check all that apply Facebook Instagram LinkedIn Twitter Your social media handle(s) OK Question Title * 16. We like to celebrate birthdays by recognizing you with your birthday peers. What is your birthdate month? January February March April May June July August September October November December Prefer not to say OK Question Title * 17. How can we improve our meetings and/or events? Check all that apply Shorter meetings Longer meetings More interactive Time for networking Time for caucusing Speakers (please list below) Activities (please list below) Discuss personal resources (please list below) Other (include your ideas here) OK Question Title * 18. How can we support you in becoming more engaged in BUILD? OK Question Title * 19. What comments do you have? OK DONE
