Exit Gender at school survey template NOTE: THIS TEMPLATE IS NOT BUILT FOR OR INTENDED FOR DISTRIBUTION TO MINORS UNDER 16 (OR A HIGHER AGE DEPENDING ON YOUR LOCATION). Visit the Acceptable Uses Policy for more information. Question Title * 1. Do you believe there is gender equality among the students at your school? Yes No Question Title * 2. How would you describe the gender representation among the faculty and staff at your school? Men are over-represented Women are over-represented Men and women are equally represented Question Title * 3. Do you think your school should make a public statement regarding the Supreme Court’s decision to overturn Roe vs. Wade? Yes, supporting the decision Yes, opposing the decision No My school has already released a statement Question Title * 4. How much do you agree or disagree with the following statement: Supporting access to reproductive care, including abortion, demonstrates a school’s commitment to supporting and advancing women. Strongly agree Somewhat agree Somewhat disagree Strongly disagree Question Title * 5. Given the Supreme Court decision, are you considering doing any of the following? Switching to a school that offers more reproductive healthcare benefits, information, or aligns with my personal beliefs Switching to a school that doesn’t offer reproductive healthcare benefits, information, or aligns with my personal beliefs I am not considering switching schools Question Title * 6. Does your school allow its students to openly protest or express their beliefs related to social issues? Yes No Question Title * 7. Which race or ethnicity best describes you? (Select all that apply) White Hispanic or Latino/a Black or African-American Asian or Asian-American Middle Eastern or North African Native Hawaiian or Pacific Islander Native American or American Indian Other (please specify) Question Title * 8. What is your age? Question Title * 9. Which of the following best describes your affliction with the school? Staff / Faculty Student Other (please specify) Question Title * 10. Which gender best describes you? Male Female Non-Binary Not listed/non-conforming Done