21-DAY EQUITY CHALLENGE PRE-SURVEY

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

Why did you sign up for the challenge? (Choose your TOP response) *

I want to learn more about race equity and social justice

My supervisor or employer suggested it

My team is doing the challenge together

I want to be more active in race equity and social justice issues

Other (tell us more)

What are your goals and intentions for the 21-Day Equity Challenge? (Choose your PRIMARY reason) *

Learn more about myself and community

Shift my way of thinking

Engage with people from different backgrounds than my own

Shift how I interact with others in my community

Help my employer and/or team address issues of race equity and social justice

Learn how to get involved with advocacy and making changes in my community

Lead or join efforts to make changes in my community

Other (tell us more)

How will you ensure that you stay committed for the full 21 days of the challenge? (Choose your TOP Strategy) *

I will prioritize this work and make time for it each day

My team will help support me to stay engaged

I will offer to lead and/or support group discussions with my team or network

I will practice self-care during the challenge (ex. stress management)

Not sure

Other (tell us more)

Imagine that it is the last day of the Challenge, how will you know that you have succeeded? (What will success look like for you?) *

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

This form was created inside of Wellesley Public Schools. Report Abuse