JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Audience Survey
Thank you for watching SURVIVOR MADE and filling out this short survey. Your responses help guide our impact campaign. If you are uncomfortable with a question, feel free to leave it blank.
Sign in to Google
to save your progress.
Learn more
Your Name
Your answer
Your Organization
Your answer
Your Email
Your answer
Where did you watch SURVIVOR MADE?
At home with video on demand
In a community space
In a theater
Other:
Clear selection
Where do you currently live?
Your answer
We'd love to hear from you! Please share your thoughts on SURVIVOR MADE. What stood out to you about the film, and how did it make you feel?
Your answer
After watching SURVIVOR MADE, I have a better understanding of: (Select all that apply)
The many forms of gender-based violence beyond physical harm
The crucial role of financial independence in breaking cycles of abuse and supporting survivor well-being
The different ways gender-based violence affects people and the unique healing journeys that follow
None of the above
Other:
After watching SURVIVOR MADE, I feel inspired to: (Select all that apply)
Share the movie with my friends, family, and networks
Have meaningful conversations with loved ones about gender-based violence
Seek out and support survivor-led businesses in my community
Learn more about healthy relationships
Advocate for policies that will protect survivors’ financial assets
None of the above
Other:
In your opinion, does SURVIVOR MADE differ from other films or media that explore gender based violence? If so, in what way(s)?
SURVIVOR MADE focuses on stories of possibility where other narratives focus on trauma
SURVIVOR MADE shows a range of different survivor experiences and identities
SURVIVOR MADE follows survivors into the next chapter of their lives, rather than ending after the abuse stops
SURVIVOR MADE shows the different facets of survivor healing: financial empowerment, a sense of purpose, community, self care, etc.
This film does not differ from other films or media
Other:
OPTIONAL:
Only respond if this applies to you and you want to share.
I have been subjected to gender-based violence, and after watching SURVIVOR MADE, I feel:
Witnessed and seen
That the cast’s experiences resonated with my own
That my experiences were reflected in ways I haven’t often seen in films
I have not been subjected to gender based violence.
Other:
Can we include your responses in our impact campaign? Our film celebrates community, and we’d love to share these stories with your voice!
Yes, you can share my responses anonymously
Yes, you can share my responses with my city and first name
No, please do not share my responses publicly
Clear selection
Survivor-entrepreneurs, join the GIFTED community! Check the box to learn more about selling on GIFTED.
Learn more
Would you like to join our newsletter?
Yes, sign me up
No
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of FreeFrom.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report