Factfinding Survey for New Aim Constituency Group Serving Hoosier African American Municipal Officials

We want to learn about you and what you want to see from this important new group!

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* 1. Regarding the breakfast for black municipal officials at the Aim Ideas Summit:

I will attend

I cannot attend

I did attend

I missed it

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* 2. General Contact Information

Name: *

Title: *

Municipality/Company:

Address:

City/Town:

State:

ZIP:

Email Address: *

Phone Number: *

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* 3. If you have an assistant, please provide their contact information below.

Name:

Email Address:

Phone Number:

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* 4. My gender identity is

Female

Male

Non-Binary

Other (please specify)

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* 5. I Identify as Black/African American

Yes

Other (please specify)

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* 6. In what year did you begin your first term in your current office?

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* 7. Have you ever held a different municipal office?

Yes

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* 8. If you answered yes to the above question, please indicate which municipal office or offices you have previously held.

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* 9. Please provide any social media handles you use.

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* 10. From the following list of topics, please identify your three top policy priorities.

Economic Development

Housing

Public Safety

Road/Infrastructure Maintenance

Delivery of Municipal Services

Public Transportation

Health

Education

Maintaining Public Spaces

Unsheltered/Unhoused

Other (please specify)

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* 11. When you think about the priorities you identified above, what are two barriers holding up your progress?

Gaining Support of Stakeholders

Obtaining Credible Information on Topics Important to Me and My Constituents

Securing Adequate Funding

Other (please specify)

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* 12. How can Aim best support your success as an elected official?

Access to relevant training, information, and best practices

Growing and leveraging my network

Partnering me with a mentor

Opportunities for me to share and learn with colleagues across the state

Other (please specify)

Factfinding Survey for New Aim Constituency Group Serving Hoosier African American Municipal Officials

We want to learn about you and what you want to see from this important new group!

Question Title

* 1. Regarding the breakfast for black municipal officials at the Aim Ideas Summit:

Question Title

* 2. General Contact Information

Question Title

* 3. If you have an assistant, please provide their contact information below.

Question Title

* 4. My gender identity is

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* 5. I Identify as Black/African American

Question Title

* 6. In what year did you begin your first term in your current office?

Question Title

* 7. Have you ever held a different municipal office?

Question Title

* 8. If you answered yes to the above question, please indicate which municipal office or offices you have previously held.

Question Title

* 9. Please provide any social media handles you use.

Question Title

* 10. From the following list of topics, please identify your three top policy priorities.

Question Title

* 11. When you think about the priorities you identified above, what are two barriers holding up your progress?

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* 12. How can Aim best support your success as an elected official?

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* 13. Do you have any suggested topics for a future event or seminar?

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* 14. If you have a suggestion for the name of this new Aim constituency group, please share it!