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1. First Name (Required.)

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2. Last Name (Required.)

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3. Email Address (Required.)

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4. Phone Number (Required.)

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5. Street

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6. City (Required.)

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7. State (Required.)

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8. Zip Code (Required.)

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9. Organization (Required.)

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10. Type of Judicial Officer (Required.)

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11. Type of court or proceedings handled (please select all that apply)

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12. Please indicate the total number of years you have been a judicial officer.

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13. Please indicate the total number of years you have encountered immigrant crime victims in your court.

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14. Please indicate the total number of years you have encountered victims of sexual exploitation or other forms of human trafficking (e.g. sex or labor) in your court.

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15. What are some issues related to human trafficking victims and/or immigrant crime victims that you are most interested in learning about from other experienced judges?

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16. What are some challenges you have encountered in your work with human trafficking victims, immigrant victims of domestic violence and/or sexual assault, child victims, or elder victims that you would like to address and obtain helpful strategies for from other experienced judges?

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17. Will you need any accessibility accommodations? (Required.)

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