Pre-Event Survey
We're excited to have you join us at the event! To sign up for the event you must complete the following survey below; the questions are so that we can learn a little bit about you. Your answers will help us make sure you have an incredible experience. 😬
Email address *
Full Name *
Your answer
Age Range? *
Location of upcoming event? *
Example: Chicago, IL
Your answer
In the last month, how often have you socialized with individuals of different ethnic, racial, or cultural backgrounds than your own? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you felt that you were making positive connections with others? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you felt isolated or singled out? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you been able to engage in meaningful, thought provoking, and challenging conversations? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you agreed to participate in new activities? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you felt confident about your ability to bond with others? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you felt empowered? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you felt an inability to relate to others? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how many times have you been fearful of what strangers may think of you? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you declined a new opportunity? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
In the last month, how often have you wished to have more meaningful conversations? *
0 = Never 1 = Almost Never 2 = Sometimes 3 = Fairly Often 4 = Very Often
Never
Very Often
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