Kavod Membership Census 2023-2024

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for affirming your support for the Kavod community and building power with us by becoming a Kavod member!

First Name *

Last Name *

Birth Date *

YYYY

Phone number *

Email address *

Street Address *

Include house#, street, apt#

City *

State *

Zip code *

Tell us about yourself

Check as many as apply to you in the checkbox questions. All questions are optional.

Racial and ethnic identities

Black

White

Latinx

Arab and/or Middle Eastern/North African

East Asian

South Asian

Indigenous/First Nation

European Descent

Caribbean Islander Descent

Pacific Islander Descent

African Descent

Mixed race/multiracial

Mizrahi

Sephardi

Ashkenazi

Other:

Gender Identity

Gender pronouns (e.g. she, he, they, he/she) or a short description of your gender identity

Do you identify as a person with a disability/a disabled person?

I grew up... ( See the definitions next to each class option for guidance.)

Poor or Working-Poor - Life experience often includes: Chronic lack of food, healthcare, or other necessities. High dependence on public safety nets. Unstable and/or substandard housing. Employment is difficult to attain, often paid minimum wage or lower, often under the table. Little access to higher education.

Working-Class - Life experience often includes: Living paycheck to paycheck with little or no savings and often with debt from education, medical or other expenses. Sometimes unstable housing. Occupation often involves physical labor, service or care work for upper and middle-class people. Little control over pay, hours, or access to benefits, and spotty access to higher education with large amounts of debt.

Middle-Class - Life experience often includes: Dependence on wages/salaries to pay the bills, some amount of savings. Homeownership or other generally stable housing. Generally stable employment (but status can become precarious when there are unexpected expenses or layoffs).College is generally expected.

Managerial/Upper-Class - Life experience often includes: Basic necessities are covered by salaried employment. Owning one or multiple homes, traveling (including internationally). Dependence on salaries (rather than investments) to pay bills. Potentially receiving or passing down significant inheritances.Education at elite/selective colleges or public universities often without student loans.

Owning-Class - Life experience often includes: Having enough income from assets (stocks, bonds, etc) that full-time work is optional. Owning one to multiple luxury homes. Higher Education at elite/selective private schools and colleges without loans. Receiving and/or passing down large inheritances.

I'm not sure

How do you spend your days?

work, school, anything!

Anything else you want to share about yourself or your identities?

If you are a new member, tell us how you found your way to Kavod:

Friend

Kavod's website

Social media

Another organization

Other:

Thank you for your contribution to your Kavod membership. Please let us know the amount of your donation here.

Clear form

Never submit passwords through Google Forms.

This form was created inside of Kavod Boston.

Does this form look suspicious? Report

Forms