In order to plan events and that are meaningful and useful, we need to know more about you.

Please answer as many questions as you feel comfortable answering.  humanKIND will not share this information with anyone.  Our mission is to celebrate diversity and build community. By getting to know you and what you need and want we can target our efforts.

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* 1. What is your gender?

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* 2. Please tells us about your Race/Ethnicity and Religion.

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* 3. What is your age?

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* 4. How many people currently live in your household? 

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* 5. Do you live

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* 6. humanKIND wishes to address issues of interest concerning diversity, justice, peace, and fostering understanding, tolerance, and building community in our neighborhood.  Please rank the following issues in order of interest/concern to you. ( #1 being most interested/concerned # 7 being least interested/concerned.)

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* 7. humanKIND would like to organize and offer events and opportunities to celebrate diversy, create awareness, and build community on the Eastside Hill.  How likely would you be to participating in any of these if offered?

  Not Likely Somewhat Likely Very Likely
Educational Speakers/Presentations on a Topic
Social Gatherings - Block Parties/Potlucks/ Picnics
Social Gatherings - Musical Jam Sessions/ Family Music Events/ Community Singing
Social Gatherings - Game Playing
Social Gatherings - Hobby Groups
Social Gatherings  - Celebrations of Holidays across Cultures
Social Gatherings - Dances
Book Study/Discussion Group on a Topic
Time Bank- Creating a Service Exchange for neighbors to give of their skills/time in exchange for services provided by another neighbor.

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* 8. How true do the following statements feel to you?

  Not true at all Somewhat true Neutral or Not Sure Mostly true Very true
I feel safe in my neighborhood.
I know my neighbors.
I am known by my neighbors.
I feel welcome in my neighborhood.
I feel at home in my neighborhood.
I like my neighbors.
I am liked by my neighbors.
My neighborhood is a positive place to live.
My neighborhood is a peaceful place.
My neighborhood is a good place to raise children.
My neighbors are friendly.
I like living in my neighborhood.

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* 9. Do you have any other comments or concerns?

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* 10. How would you like to become more involved? (check as many as apply)

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