Mapping Racial Trauma
This form collects information about incidences of racialized trauma caused by either interpersonal violence from a teacher or student OR activities, assignments, field trips, or simulations created by a teacher or team of teachers. If you are willing to share your story or being willing to be interviewed, please fill out the form. All responses and identifying information will be kept confidential.
*Please note that this research is my own and does not represent the views of Grinnell College.
Sign in to Google to save your progress. Learn more
In the area below, please describe the incident you would like to share. *
Are you willing to be interviewed about your story? *
Are you willing to have your story published on this website? *
What is your name? *
What is your email address?
What is your phone number?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.