Questionnaire for Conversation Diversity
Labels can put us in boxes. This said, diversity in a Living Room Conversation adds to the quality of the conversation. If you can give us some sense of where you identity on the dimensions represented below it will help us create greater diversity in your conversation. All of the questions below are optional and the information is only used for the formation of diverse conversation groups. Thank you!
Organization (if applicable)
Are you interested in participating in a Living Room Conversation in-person, via video/web-enabled conferencing, or both?
Via video or web enabled conference tools
New England (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)
Mid-Atlantic (Delaware, New Jersey, New York, and Pennsylvania)
East North Central (Illinois, Indiana, Michigan, Ohio, Wisconsin)
West North Central (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota)
South Atlantic (Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, District of Columbia, and West Virginia)
East South Central (Alabama, Kentucky, Mississippi, Tennessee)
West South Central (Arkansas, Louisiana, Oklahoma, Texas)
Mountain (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming)
Pacific (Alaska, California, Hawaii, Oregon, Washington)
other (outside of U.S.)
Political leaning on social issues (e.g. marriage, abortion, gun control, etc.)
Political leaning on fiscal matters (e.g. taxes, trade, government spending, privatization, etc.)
Please identify where you would place yourself on this spectrum.
You value a high degree of personal liberty with freedom from interference.
You value a high degree of predictability and security through social practices.
Political party you most identify with
14 - 20
21 - 30
31 - 40
41 - 50
51 - 60
61 - 70
White or European descent
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native
Two or More Races
Conversation topics that interest you?
To participate in a Living Room Conversation we ask you to agree to follow these common-sense ground rules: 1) Be curious and open to learning; 2) Show respect and suspend judgment; 3) Find common ground and appreciate differences; 4) Be authentic and welcome that from others; 5) Be purposeful and to the point; and 6) Own and guide the conversation
Yep, I can do that!
Nope, this isn't for me.
Please let us know your generally preferred availability for participating in a 2 hour conversation.
We often take photos, record, and/or live-stream conversations and use these materials on our website, Facebook, and in other promotional materials. Do we have your permission?
Maybe, but first I'd like more information.
Anything else you'd like to share about yourself?
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