Registering / Goal Setting for 21-Day Racial Equity and Social Justice Challenge 2020

21-Day Racial Equity and Social Justice Challenge 2020

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Thank you for signing up for the 21-Day Racial Equity & Social Justice Challenge. By submitting your email, you agree that you would like to be added to YWCA Knoxville and the Tennessee Valley's email list. You may unsubscribe from communications by clicking the unsubscribe link in the email. If you have changed your mind and do not wish to participate, please do not submit this form. Direct questions to Karlyn Reel at kreel@ywcaknox.com.

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Zip Code

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* 5. Age Group

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 6. Race/Ethnicity (Choose as many as apply)

Native American/Indigenous/Alaskan Native

Asian

Black or African American

Native Hawaiian or other Pacific Islander

Hispanic/Latino, Latina/Latinx

Middle Eastern or North African

White

Multiple Races

Other

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* 7. How did you hear about the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

Social Media (ex. Facebook, Instagram, etc.)

Newsletter or email from YWCA Knoxville and the Tennessee Valley

Friend or family member

My supervisor or employer

A colleague or coworker

Other (please specify)

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* 8. Why did you sign up for the challenge? (choose all that apply)

I want to learn more about race equity and social justice

My team is doing the challenge together

I want to be more active in race equity and social justice issues

Other (please specify)

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* 9. What are your goals and intentions for the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

Learn more about myself and community

Change my way of thinking

Engage with people from different backgrounds

Change how I interact with others in my community

Help my employer and/or team address issues of race equity and social justice

Learn how to get involved with advocacy and making changes in my community

Lead or join in efforts of make changes in my community

Other (please specify)

Registering / Goal Setting for 21-Day Racial Equity and Social Justice Challenge 2020

21-Day Racial Equity and Social Justice Challenge 2020

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Zip Code

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* 5. Age Group

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* 6. Race/Ethnicity (Choose as many as apply)

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* 7. How did you hear about the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

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* 8. Why did you sign up for the challenge? (choose all that apply)

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* 9. What are your goals and intentions for the 21-Day Race Equity and Social Justice Challenge? (choose all that apply)

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* 10. What can the 21-Day Challenge organizers do to help you succeed?