CA Racial Justice Act Community Survey

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Thank you for providing information in this survey. Your answers are voluntary and will be confidential. Responses will not be identified by individual, rather by organization. A member of The Racial Justice Act Implementation Working Group will follow up with you to gather more information as needed.

Email *

What is your name and email address?

What organization are you completing this survey on behalf of?

In which county is your organization located?

What is your name and what is your title within the organization?

What is your organization's geographic service or organizing area?

Which of the following impacted communities do you serve or organize with?

Black, brown, native, Indigenous, and people of color

LGBTQ+

Immigrants

Targeted gang members

Individuals experiencing homelessness

Individuals experiencing drug dependency

Youth

Individuals on probation/on parole or currently or formerly incarcerated

None of the above

Other:

What percentage of your clients or members fall into these impacted communities?

80-100%

60-80%

40-60%

Less than 40%

Clear selection

Do you hold information, including stories or other data about racism or discrimination in your community?

Yes

Prefer not to answer

Clear selection

If you answered yes above, do you hold information on any of the following (check all that apply):

Race

Police violence

Drugs

Gangs

Homelessness

Incarceration/Juvenile Deliquency

Other:

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