Building Power for #WIFights292
Brief and voluntary survey to gauge interests on social issues and knowledge on the Unborn Child Protection Act (Act 292).
Part 1 will be answering basic questions about yourself.
Part 2 will ask questions about Act 292 and Reproaction.
Part 3 will let you indicate what social issues you care most about.
This survey will take no more than 10 minutes to complete.
(Please email if you would like to speak with Reproaction's Wisconsin organizer)

*By taking this survey, you will NOT be automatically enrolled in Reproaction's email list. Please go to if you would like to opt-in to the email list*

Name (First and Last) *
Your answer
Email address *
Your answer
Which age group do you fall into?
Do you live in Wisconsin? *
If yes, please answer the following question.
What zip code are you living in?
Your answer
Are you familiar with Reproaction and the work that Reproaction does around reproductive justice and abortion access? *
Are you familiar with the Unborn Child Protection Act (Act 292)? *
Are you interested in learning more about Act 292? *
On a scale of 1 - 10 (1 being not at all, 10 being extremely), how concerned are you with the enforcement of the Unborn Child Protection Act? *
Would you be interested in becoming a regular volunteer with Reproaction? *
This would be no more than 1-10 hours per month, unless indicated otherwise (see below)
Would you be interested in taking on a leadership role with Reproaction on a volunteer basis? *
On what social issues are you most interested in? *
Please choose no more than 3 issues
How many hours per month are you able to commit to issues that you care about?
Are you interested in attending events about the issues you care about in your area?
Are you interested in engaging in direct actions for the issues you care about?
Are you interested in attending trainings around issues you care about?
Including direct action, workshops, advocacy trainings, and more
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service