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* 1. How many times have you attended Cafe Cultura’s monthly open mic over the last year?

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* 2. How many Café Cultura spoken word workshops have you participated in over the last year?

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* 3. Over the last year, how many times have you attended a Café Cultura event/performance at an educational institution (university, college, high school, middle school)?

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* 4. How many Cafe Cultura-published books have you read (from CC poets and/or workshop participants)?

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* 5. How did you hear about Café Cultura events, performances, and/or workshops?
(feel free to choose more than 1)

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* 6. What have you enjoyed about Cafe Cultura’s programming?
(feel free to choose more than 1)

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* 7. Cafe Cultura has had a positive impact on me and/or my group...

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* 8. What is your most memorable moment of Cafe Cultura (open mic, workshop, performance, etc)?

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* 9. Café Cultura has taken steps to fulfill its mission (Café Cultura’s mission is to promote unity and healing among Indigenous peoples through creative expression while empowering youth to find their voice, reclaim oral and written traditions, and become leaders in their communities)

  Strongly Disagree Strongly Agree
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* 10. What can Cafe Cultura do to improve?

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* 11. What specific topics would you like Cafe Cultura to address in our open mics and other programming?

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* 12. What local artists would you like Café Cultura to feature at our open mic?

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* 13. What out-of-state performers would you like Cafe Cultura to feature at our open mic?

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* 14. How would you like to support Café Cultura? (If you want to be contacted about any of your choices, please write in your contact information)

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* 15. Other comments or suggestions

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* 16. Your age:

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* 17. Your gender:

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* 18. Your sexual orientation:

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* 19. Your race and/or ethnicity (you may choose more than one):

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* 20. Family Income:

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