Exit this survey Racism Survey 1. 100% of survey complete. Question Title * 1. What is your name? If you want to remain anonymous use a fake name. Your responses (or part of them) may be read on the podcast or published. Question Title * 2. What is your sex/gender? Male/Man Female/Woman Transwoman Transman Genderfluid Agender Other (specify in text box below) Other (please specify) Question Title * 3. How old are you? Under 18 (specify in box that reads "other") 18-19 20-29 30-39 40-49 50-59 60-69 70 and over (specify in box that reads "other") Other (please specify) Question Title * 4. What is your race/ethnicity White or Caucasian Black or African American Hispanic or Latino Asian or Asian American Arab Jewish Persian American Indian or Alaska Native Native Hawaiian or other Pacific Islander Mixed race or one not listed here. Elaborate in the box below. Question Title * 5. Share any experiences you have had with racism, when it happened and how old you were. Question Title * 6. Do you remember how you felt when it happened? Question Title * 7. How do you feel about it now? Question Title * 8. Any thoughts or feelings you'd like to share? Done
