Personal Safety & Self-Defense Survey
BACKGROUND:
- Hello! My name is John Kotarski and I am a rising sophomore at the University of Michigan studying Computer Engineering.

- After hearing stories of people in my life being put in situations in which they feel powerless (including but not limited to countless stories of harassment and sexual assault), I became passionate about helping my peers feel safe both on campus and beyond, as I know that the stories I've heard were the few that people felt comfortable sharing.

- It would mean a lot if you would take the time to answer the questions below in order to help me help as many people as possible. Thank you!

CONTACT:
- For more information, please contact myself, John Kotarski, via email: protechtsafetytech@gmail.com

- Follow us on Instagram and TikTok @protechtsafetytech
Sign in to Google to save your progress. Learn more
Email *
Full Name *
How did you discover this survey? (If other, tell us who referred you to get yourself and them an extra entry to win the $25 Amazon Gift Card). *
Please select your age range: *
What gender do you present as? *
How often do you feel at risk of assault/any type of harm? *
Do you carry a self defense device? *
Which of the following safety apps do you currently have/use? *
Required
What is the typical cost of a self-defense device that you currently own? (If you own multiple, pIease list what they are and their price in "Other"). *
What is most important to you in a self defense device?(Please rank the following, 1 being most important). *
1
2
3
4
5
6
7
8
9
Appearance
Ergonomics
Control
Cost
Discrete
Distance
Size
Reliability
Usability
Tell us a story about the most recent time you used a self-defense device. (If not applicable, write "N/A"). *
What challenges are you currently experiencing with regards to personal safety and self defense? *
What do you wish you knew or had that would make you feel safer in your daily life? *
(Optional) Speak freely about your relevant experiences and/or bring up anything at all that you feel is relevant that was not asked/mentioned in the survey.
Can we follow up with you to learn more about your experiences regarding personal safety and self-defense?(One-on-One outreach/interviews). *
Would you like to join our mailing list for updates? Must check yes to be eligible for the Amazon Gift Card.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google.