Local Group BIPOC Caucus Survey
350.org recognizes the importance of supporting and empowering BIPOC (Black Indigenous and People of Color) local group members. As part of our commitment to becoming a multiracial organization that organizes a multiracial base we hope to support our local groups in creating truly inclusive and diverse spaces that center BIPOC leadership.

One way we hope to support BIPOC local group members is by creating a BIPOC caucus - a space to connect, discuss justice and equity issues and practices and get support from one another. The purpose of this survey is to gauge BIPOC local group members' interest in participating in such a caucus as well as gather feedback on what would make this caucus most useful.

If you are interested in participating in a BIPOC caucus please fill out this survey as well as the Doodle linked below so that we can schedule an initial virtual meeting between interested local group BIPOC members to gather feedback on the purpose and function of the BIPOC caucus. Please fill these two items out by Tues April 2, 2019.

Doodle to fill out:
https://doodle.com/poll/k335a8v4c9gmkacy

Full Name *
Your answer
Email *
Your answer
Phone *
Your answer
Name and Location of Local 350 Group *
Your answer
Racial/Ethnic Background *
Examples: Asian/Pacific Islander, Black/African Descendant, Indigenous/American Indian/Native American, Latinx, White, Person of Color, Multiracial/Biracial/Mixed-Race or other ways you identify.
Your answer
On a scale of 1 to 5 indicate your interest in regularly participating in a BIPOC caucus for local group members *
Not interested at all
Very interested
What do you hope to get out of a BIPOC caucus? Check all that apply. *
Required
If you marked "other" on the previous question, please elaborate here.
Your answer
Do you know of any other BIPOC local group members who might be interested in participating in a BIPOC caucus? If so, please share their name and contact info here.
Your answer
Any other comments about the formation of a local group BIPOC caucus?
Your answer
350.org staff are planning to convene local group BIPOC members in an initial virtual meeting to gather input on the BIPOC caucus. To do so, we are asking those interested to fill out this doodle. Check this box if you have filled out the Doodle linked here: https://doodle.com/poll/k335a8v4c9gmkacy *
Required
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