Jewish Staszow Survey
I have created a questionnaire as part of my doctoral dissertation "Jewish Staszow as Site of Memory." I am reaching out to you because of your connection with Staszow, and would appreciate your spending 10-15 minutes completing the document below. Thanks in advance, Passi Rosen-Bayewitz

Why Jewish Staszow Memory Matters?
Introduction:
• You are being asked to complete a questionnaire on the role of Jewish Staszow as a site of memory.
• You are selected as a possible respondent because of your connection to Staszow as a result of familial, genealogical, historical and/or academic interests.

Confidentiality:
• The results of this questionnaire will be kept strictly confidential. All electronic information will be coded and secured using a password protected file.

Consent:
• The purpose of this questionnaire is to analyze why and how Jewish Staszow, a small town in Poland, mattered and continues to matter to individuals scattered across the globe. The questionnaire also addresses ways to preserve Jewish Staszow memory for the future.
• The results of this questionnaire will be published as part of a dissertation “Jewish Staszow as Site of Memory” written by Passi Rosen-Bayewitz, in fulfillment of the Doctor of Letters (D.Litt.) degree program at Drew University. http://www.drew.edu/graduate/academics/arts-letters.
• There is no physical or psychological risk involved in this questionnaire. You are free to withdraw participation at any time.
• The responses will be anonymous; the results will be presented as an aggregate; the gathered
data will be kept confidential.

By participating in this questionnaire, you agree that any information obtained may be used in any way thought best for publication or education provided that you are in no way identified and your name is not used.

Participation in the questionnaire indicates you have agreed to participate in the study.

If you have any questions or problems concerning your particiption in this questionnaire, please contact Dr. William Rogers, Associate Dean of the Caspersen School, Drew University, wrogers@drew.edu., 1-973-408-3283.

Section A
i. Would you say that the memory of Jewish Staszow matters to you?
ii. If yes, please tell us why. Below are some of the points that different people have shared with us about why Staszow memory matters to them or what drives their interest. Which points are more in-line with what you are thinking or feeling? Choose and check up to five.
If you have other reasons, please list them below.
Your answer
Section B
In what way(s) do you sustain the memory of Jewish Staszow? Below are some of the ways that people have shared with us about how they sustain Staszow memory. Which points reflect some of the actions that you have taken over the years? There is no limit to the number of points you may choose to check.
If you have other reasons, please list them below.
Your answer
Section C
If you have anything else you would like to share about your engagement in Jewish Staszow memory work, please indicate below.
Your answer
Thank you so much for completing this questionnaire.
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