Respond Anonymously - 10 Questions About Rape

 
Please Read Instructions Before Proceeding
*
1. The purpose of this research project is to obtain information to help develop anti-rape strategies in African American/Black communities. This is a research project being conducted by Black Women's Blueprint. Your participation in this research study is voluntary. The procedure involves filling an online survey that will take approximately 5 minutes. Your responses will be anonymous and we do not collect identifying information such as your name, email address or IP address. The results of this study will be used for scholarly purposes only and for community organizing purposes. If you have any questions about the research study, please contact info@blackwomensblueprint.org.

ELECTRONIC CONSENT: Please select your choice below.
Clicking on the "agree" button below indicates that: You have read the above information, you voluntarily agree to participate, you re at least 18 years of age
*
2. Zip Code?
*
3. How Old Are You?
*
4. Gender?
*
5. Race?
*
6. What Is Sexual Assault?
*
7. Have You Ever Been A Victim Of Sexual Assault?
*
8. Was the person Black?
9. Age When Assault Occurred?
*
10. Have You Ever Sexually Assaulted Someone?
*
11. Why Does Sexual Assault Happen In Black Communities?
*
12. What Would It Take To End Sexual Assault in Black Communities?
13. If you need resources or support please visit:

Men Can Stop Rape - www.mencanstoprape.org
Feminist Majority - http://feminist.org/911/resources_af.html
RAINN - www.rainn.org or call (800) 656-HOPE
A Long Walk Home - www.alongwalkhome.org or call (877) 571-1751

Any additional comments:
Powered by SurveyMonkey
Check out our sample surveys and create your own now!