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Section 1 of 5
Standard Demographic Data Collection Tool (for Internal Use Only)
This is an internal survey for nonprofit organizations to use to gather demographic data from their teams.

Sharing this with your board members and staff will allow you to collect demographic in a standardized and consistent fashion.

NOTE:  This is a template!  DO NOT enter data into this form; instead, please complete the following instructions to set this form up for internal use.

You will need a Google Account to use this form.

1.  Log in to your Google Account

2.  Click on the three vertical dots in the upper right-hand corner of this form

3.  Select the "Make a Copy" option on the menu that appears

4.  Place the form in the appropriate location in your own Google Drive.  DO NOT select "Share it with the same people"

5. Add your organization's contact information to the privacy policy question.

You're all set!  The form is now ready to accept data.  At this point, if you need to collect additional information within your organization, you can learn how to add questions or answer options with the Google Forms guide: https://support.google.com/docs/answer/6281888?hl=en&co=GENIE.Platform%3DDesktop.

To share it with your coworkers:

1.  Click "Send" in the upper right corner

2.  Click on the "Link" icon next to "Send Via".  This will generate a customized link for you to use

3.  Paste this link into an email and share it with your team!

You can also share this link as you onboard new hires and board members, so that all of your demographic information is collected in one place. A Google account is not necessary for your team members to complete the form.

To view responses from your staff, click on the "Responses" tab in the top middle of the screen.

______________________________________________________________________________________________________________ After copying to a new draft, please delete all content above and including this sentence of instructions. This will clean up the form and it will now be ready to send to your organization team ______________________________________________________________________________________________________________

This Demographic Data Collection form is an internal survey specifically for our organization to gather data from our staff and board members to allow people to self-identify their demographics.

In aggregate, this data can be used to fill out grants, grant reports, and to complete the Statewide Nonprofit Leadership Census. The individual data will remain within our internal organization.
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 By completing the demographic data collection form, you are providing informed consent so that we may report on your demographic data when appropriate. I have read and agreed to the above policy.
Question Type
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Yes
No, I have questions and would like to talk to someone. Please contact: INSERT ORG CONTACT INFORMATION HERE
Maybe
Add option
or
add "Other"
Answer key
(0 points)
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Please select your role within the organization:
Question Type
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Executive Director
Board Member
Staff Member
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or
add "Other"
Answer key
(0 points)
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Section 2 of 5
Executive Director Questions
These questions are asked only for the Executive Director.
Executive:  What is your gender identity?
Question Type
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Cis-woman
Cis-man
Woman (non cis-gender)
Man (non cis-gender)
Genderqueer or non-binary
Gender noncoforming
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Executive:  What is your race/ethnicity?  Please select all that apply:
Question Type
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Arab/Arab American
Asian/Asian American
Biracial/multiracial
Black/African American
Caribbean/Caribbean American
Hispanic or Latino/a/x
Indigenous, American Indian, or Alaska Native
Native Hawaiian or Other Pacific Islander
White
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Are you the first Black, Indigenous, or person of color to lead this organization?
Question Type
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Yes
No
I do not identify as Black, Indigenous or a person of color.
Add option
or
add "Other"
Answer key
(0 points)
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Are there any other identities that you hold (ex: religion, disability, veteran status, etc.)?
Question Type
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Answer key
(0 points)
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What's your age?
Question Type
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19 years old or UNDER
20-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65 years old or OLDER
Prefer not to say
Add option
or
add "Other"
Answer key
(0 points)
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How many years have you been in this position?
Question Type
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Less than 1 year
1-5 year (s)
6-9 years
10+ years
Add option
or
add "Other"
Answer key
(0 points)
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Section 3 of 5
Board Member: Race/Ethnicity
What is your gender identity?
Question Type
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Cis-woman
Cis-man
Woman (non cis-gender)
Man (non cis-gender)
Genderqueer or non-binary
Gender noncoforming
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Board:  What is your race/ethnicity?  Please check all that apply:
Question Type
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Arab/Arab American
Asian/Asian American
Biracial/Multiracial
Black/African American
Caribbean/Caribbean American
Hispanic or Latino/a/x
Indigenous, American Indian, or Alaska Native
Native Hawaiian or Other Pacific Islander
White
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Section 4 of 5
Staff Member: Race/Ethnicity Question
Staff:  What is your gender identity?
Question Type
Loading image…
Cis-woman
Cis-man
Woman (non cis-gender)
Man (non cis-gender)
Genderqueer or non-binary
Gender noncoforming
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Staff:  What is your race/ethnicity?  Please select all that apply:
Question Type
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Arab/Arab American
Asian/Asian American
Biracial/Multiracial
Black/African American
Caribbean/Caribbean American
Hispanic or Latino/a/x
Indigenous, American Indian, or Alaska Native
Native Hawaiian or Other Pacific Islander
White
Prefer not to say
Other…
Add option
Answer key
(0 points)
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Section 5 of 5
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Untitled Title
 By completing the demographic data collection form, you are providing informed consent so that we may report on your demographic data when appropriate. I have read and agreed to the above policy.
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No responses yet for this question.
Please select your role within the organization:
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No responses yet for this question.
Executive Director Questions
Executive:  What is your gender identity?
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Executive:  What is your race/ethnicity?  Please select all that apply:
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Are you the first Black, Indigenous, or person of color to lead this organization?
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Are there any other identities that you hold (ex: religion, disability, veteran status, etc.)?
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What's your age?
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How many years have you been in this position?
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Board Member: Race/Ethnicity
What is your gender identity?
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Board:  What is your race/ethnicity?  Please check all that apply:
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Staff Member: Race/Ethnicity Question
Staff:  What is your gender identity?
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Staff:  What is your race/ethnicity?  Please select all that apply:
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