1.Are you answering on behalf of yourself or an organization/group?(Required.)

Myself

Organization/Group

2.If the latter, what organization/group?

3.Zip Code(Required.)

4.What is the specific problem related to racism that needs to be addressed?(Required.)

5.What strategy/ies do you suggest will address this problem?(Required.)

6.Who do you think is best to lead this change?(Required.)

7.What can you pledge to do to support positive change?(Required.)

8.Do you have a personal experience/observation that demonstrates the problem you shared above?

9.Are there any other comments / questions you would like to share?