Anti-Racism Declaration of Action
We will use this information to learn and share what kind of actions are being taken. We will not share private or personal information.
Sign in to Google to save your progress. Learn more
What is your name? *
What is your email address? *
Type of action I took (check all that apply): *
Required
Date I took action: *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of East Bay Agency for Children. Report Abuse