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* 1. Please rate UNDIVIDE US

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* 2. Where did you see the film? (Zip Code)

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* 3. First Name

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* 4. Last Name

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* 5. Email

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* 6. Which age group do you fall into:

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* 7. What organization, business, or university are you with?

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* 8. How likely are you to recommend this film to a friend or colleague?

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* 9. After watching the film, I feel more hopeful about the trajectory of the country.

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* 10. After watching the film, I’m more likely to engage with people from my community who share different viewpoints.

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* 11. After watching the film, I am inspired to change my tone on social media.

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* 12. Did the documentary inspire you to take action? If so, how?

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* 13. Are there specific organizations you would like to recommend to us? If yes, please list those organizations here.

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* 14. Leave a short review of the film that we can share on social media with #UndivideUsMovie - this is optional, only leave a review if we have your permission to share your review publicly.

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* 15. Additional thoughts?

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