Pre-Conversation Input - The Great Reset
Thank you for committing to participate in a conversation with others in your community. You are part of a larger group of people, wanting the same thing, throughout the country via The Great Reset.

The key pillars of The Great Reset are to have conversations that afford the opportunity (1) to share with humility and (2) listen with respect. There is no agenda. The intention is to empower everyone to engage in conversation.

In order for us to better understand you, and better the conversation, please answer the short 'pre-survey'. Following the group you will be asked to fill out another.

These surveys are intended to help us build better conversations and make them more compelling to people. We believe the more people talking, and the more people willing to listen leads to better and stronger communities. PLEASE BE SURE TO COMPLETE BOTH AS SOON AS THEY ARE RECEIVED.

Again, thank you for taking part in the conversation. Your participation is imperative to bring us all just a bit closer together.

Note: While ethnicity/race is not typically asked due to the topic, this month, it was felt appropriate. Liberties were taken as the racial breakouts, listed in the census, seem far too limiting, and yet ethnic groups are too many to list. The following co-mingled list, of race/ethnicities, has been tailored in hopes of capturing the incredible colors of the fabric of people who participate in The Great Reset.
Email address *
Date of upcoming conversation (if you are not participating around a table simply use the 1st day of the current month and year) *
Your location: *
Your gender: *
Your age: *
With which of the following racial or ethnic groups do you most closely identify? *
Political persuasion: *
The topic this month is 'What is Racism'. How comfortable do you feel talking about this topic? *
Not at all
Very comfortable
In your lifetime would you say racism is getting better, worse or holding steady? *
Much worse
Increasingly better
Do you feel your race suffers at the hands of racism? *
Is the Confederate Flag a racist symbol? *
If you answered 'Depends', to 'Is it racist to fly the Confederate Flag', please elaborate, otherwise skip
Your answer
Is the swastika a racist symbol? *
If you answered 'Depends', to 'Is the swastika a racist symbol', please elaborate, otherwise skip
Your answer
In light of recent tweets and policies, do you feel the POTUS is racist? *
If you answered 'Sometimes' to 'Is the POTUS racist', please elaborate.
Your answer
Does institutional racism exist in the United States today? *
Which of the following are examples of current day institutional racism? *
Please elaborate on institutional racism here:
Your answer
Would you be okay if your child married an individual outside your race? *
Which of the following topics interest you most for future conversations? Choose all that apply *
When was the last time you had a deep conversation with someone of a very different opinion? *
Any additional comments regarding The Great Reset?
Your answer
Is there anyone you think would like to participate, around the table (or online), having conversations about relevant topics of the day? (If yes, name, email and phone)
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy