Organizing
Join us in organizing an anti-racism pro-humanity movement! Let's get connected.
Sign in to Google to save your progress. Learn more
How do you plan to participate in organizing racial trauma centers? *
Name *
State *
Social media handles *
Email *
How do you FEEL talking about race and racism and whiteness? Check all that apply

*
Never
Almost never
Sometimes
Somewhat often
Frequently
Sad
Depressed
Grief stricken
Despairing
Lonesome
Dismal
Weary
Scared
Terrified
Anxious
Nervous
Uneasy
Worried
Apprehensive
Dreadful
Hesitant
Jittery
Frightened
Intimidated
Paralyzed
Horrified
Disgusted
Nauseated
Angry
Enraged
Furious
Resentful
Infuriated
Annoyed
Frustrated
Vengeful
Hostile
Hateful
Enthusiastic
Content
Tightness in the chest – hardto breathe or pressure
Tension in the neck and shoulders – Muscles may feel stiff or sore from being held in a tense position
Clammy hands or sweaty palms – Increased perspiration as part of the body’s "fight or flight" response.
Rapid heartbeat – A racing or pounding heartbeat, sometimes called palpitations.
Headaches – Tension or migraines that come from muscle strain or heightened anxiety.
Upset stomach or nausea – Feeling queasy, or having digestive issues like a “butterfly” sensation.
Dry mouth – A sensation of your mouth being dry or cotton-like, making it harder to swallow.
Dizziness or lightheadedness – A feeling of being faint or unbalanced.
Muscle aches or cramps – Stress can cause your muscles to contract, leading to discomfort or pain.
How do you soothe yourself from racial stress? *
Required
Do you believe Black people can be racist? *
Required
Do you believe The United States is an imperial power? *
Required
Who do the police protect? *
Required
How do you feel about the term European American? *
Required
Have you engaged in shadow work? *
Required
Have you embarked on your healing journey? *
Required
Are you open to participating in an anti-racism movement? *
Required
What do you need to create an anti racism community near you? *
Do you practice your ethnic culture? *
Required
Do you prefer a public or private space to hold meetings about anti-racism? *
Required
Are you receptive to feedback from Black people? *

Do you believe that Black people have authority over their own experiences?

*

When protest is happening, are you upset if you are personally inconvenienced? Are you angered when your route to work is blocked up?

*

Have you ever donated to NAACP, BLM, or other antiracist organizations? Have you ever donated money directly to a Black or indigenous person?

*

Would you trade places with a Black person right now?

*

When a homeless person is sleeping outside of a store, should the store owner call the police?

*

True or false: CRT is currently taught in schools.

*

During the Civil Rights Movement, did you or members of your family experience violence? 

*

Do you see yourself in this picture? (include pictures such as the Apartheid South Africa pic)

*
Captionless Image
What barriers do you face in creating an anti-racism group in your town? *
Please identify the anti-racism organizations operational near you *
What is their capacity? Do they have money? *
Do they have active membership? *
Do they have regular meetings? *
Can they provide legal representation for activists? *
Can they provide physical protection for activists? *
Do they provide media access? *
Invite Kokayi to your town.
Find out how: royalstar907@gmail.com 
CashApp $KokayiNosakhere 
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report