JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Omni Collective Race Gender Sexuality Questionnaire
We want to enumerate Omni Commons expansive and extensive diversity to potential donors / grant providers: please help this effort by filling this
out.
Sign in to Google
to save your progress.
Learn more
First Name
Your answer
Last Name
Your answer
Which Omni-affiliated group are you in?
Check as many as apply
Acta Non Verba
Building Community Collective
Chiapas Support Committee
Community Liberation Programs
Counter Culture Labs
Direct Action for Farmworkers
East Bay Food Not Bombs
Free Store
Global Women’s Strike
Liberated Lens
Meals On Onewheels
Oakland Privacy
Omni Commons Management / Staff / Support
Sudo Mesh
Sudo Room
Town Fridge (East Bay)
Village of Love
Other:
What is your role in that group?
If you checked multiple groups above please list the group and your role in that group.
Your answer
What is your role to the Omni Collective?
Same as role to group above
Omni Board Member
Delegate to Omni Delgate's Meeting
(No direct Omni role)
Other:
Race & Ethnicity: How do you identify?
Asian American/Pacific Islanders/Asian
Black/African American/African
Hispanic/Latino/Latina/Latinx
Native American/American Indian/Indigenous
White/Caucasian/European
Multi-Racial/Multi-Ethnic (2+ races/ethnicities)
Decline to state
Other:
Clear selection
Gender Identity: How do you identify?
Female
Male
Non-binary
Decline to state
Clear selection
Sexual Orientation: How do you identify?
Gay, Lesbian, Bisexual, or other sexual orientations in the LGBTQIA+ community
Heterosexual or Straight
Decline to state
Clear selection
Disability Status: How do you identify?
Person with a disability
Person without a disability
Decline to state
Unknown
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
