21-Day Racial Equity and Social Justice Challenge 2019 Wrap Up Survey

By sharing your mailing address with us, you are giving the YWCA permission to send you a gift for completing the challenge.

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* 1. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is your age?

17 or younger

18-20

21-29

30-39

40-49

50-59

60 or older

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* 3. What is your gender?

Female

Male

Non-binary

Genderfluid

Agender

Prefer not to answer

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* 4. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

White

Black or African-American

American Indian or Alaskan Native

Asian

Native Hawaiian or other Pacific Islander

From multiple races

Some other race (please specify)

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* 5. Do you Identify as Hispanic or Latinx?

Yes

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* 6. Do you Identify as Middle Eastern or North African?

Yes

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* 7. What is your ZIP code?

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* 8. What is the highest level of education you have completed?

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* 9. Did you participate in the challenge as an individual or as part of a group?

As an individual

As part of a group

If part of a group, which group?

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* 10. Initially, what made you join the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

My friends were participating in the challenge.

I am interested in social justice.

I signed up to participate with my coworkers.

I wanted to make a real change in my community.

Other (please specify)

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* 11. I learned about myself and my community as a result of taking this challenge.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 12. This challenge changed my way of thinking.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 13. This challenge has helped me engage with people of different backgrounds.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 14. This challenge has changed how I interact with others in my community.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 15. This challenge has helped my employer/my team address issues of racial equity and social justice.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 16. I have learned how to get involved with advocacy and making change in my community.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 17. I feel confident that I can lead or join efforts to make change in my community.

True

Mostly True

Neutral

Mostly False

False

True

Mostly True

Neutral

Mostly False

False

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* 18. What theme impacted you the most?

Other (please specify)

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* 1. Address

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* 2. What is your age?

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* 3. What is your gender?

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* 4. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

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* 5. Do you Identify as Hispanic or Latinx?

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* 6. Do you Identify as Middle Eastern or North African?

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* 7. What is your ZIP code?

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* 8. What is the highest level of education you have completed?

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* 9. Did you participate in the challenge as an individual or as part of a group?

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* 10. Initially, what made you join the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

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* 11. I learned about myself and my community as a result of taking this challenge.

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* 12. This challenge changed my way of thinking.

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* 13. This challenge has helped me engage with people of different backgrounds.

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* 14. This challenge has changed how I interact with others in my community.

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* 15. This challenge has helped my employer/my team address issues of racial equity and social justice.

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* 16. I have learned how to get involved with advocacy and making change in my community.

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* 17. I feel confident that I can lead or join efforts to make change in my community.

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* 18. What theme impacted you the most?

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* 19. What did you learn by participating in the challenge?

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* 20. What are you going to do to follow up the challenge?

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* 21. What would you like to see the YWCA do to follow up the challenge?

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* 22. Additional feedback/comments