Human Rights Commission

Invidivual Survey

To better serve the community, the HRC is seeking ideas from residents about human rights priorities in Chelsea. The results will be used to inform the public awarenesss and educational activities of the Commission. This survey is voluntary. You may skip any question you do not wish to answer. Your answers will be confidential and any reports of the results will be summaries only.

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* 1. 1. Have you been involved in specific activities or services that focus on
human rights and social justice issues?

Yes

Other (please specify)

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* 2. In your experience, what does Chelsea do well to promote and protect human rights and social justice?

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* 3. In your experience, what could Chelsea improve upon to promote and protect human rights and social justice?

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* 4. Which of the following human rights and social justice priorities do you think should be a focus of the Human Rights Commission? Please seelct your top 3 choices.

Exclusion and marginalization

Racism

Elder abuse/fraud

Police/Community Partnerships

Bullying

Sense of belonging

Intimate partner abuse

Community Diversity

Identifying discrimination

Violence and other conflict resolution

Rights and Responsibilities

Leadership and citizen engagement

Other (please specify)

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* 5. Would you be willing to work with the HRC on a specific topic?

Yes

Please list topics of interest:

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* 6. Please select your age range:

19 and under

20 - 39

40 - 59

60 - 79

80 or above

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* 7. Please select your residency

City of Chelsea

Adjacent Township (Sylvan, Lima, Lyndon)

Other

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* 8. OPTIONAL: If you would like to keep in touch with the HRC, please provide your contact information. Your answers to the survey will be entirely confidential.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 1. 1. Have you been involved in specific activities or services that focus on human rights and social justice issues?

Question Title

* 2. In your experience, what does Chelsea do well to promote and protect human rights and social justice?

Question Title

* 3. In your experience, what could Chelsea improve upon to promote and protect human rights and social justice?

Question Title

* 4. Which of the following human rights and social justice priorities do you think should be a focus of the Human Rights Commission? Please seelct your top 3 choices.

Question Title

* 5. Would you be willing to work with the HRC on a specific topic?

Question Title

* 6. Please select your age range:

Question Title

* 7. Please select your residency

Question Title

* 8. OPTIONAL: If you would like to keep in touch with the HRC, please provide your contact information. Your answers to the survey will be entirely confidential.

* 1. 1. Have you been involved in specific activities or services that focus on
human rights and social justice issues?