Online Retreat - July 31 - August 1 , 2021 Social Locator Biographical Questionnaire
Dear Participants.
The design of this retreat is based on the needs and identities of participants, so please let us know what learnings would best serve you. Also part of our explorations together will be doing some identity work - exploring different facets of our biological and socialized identities including areas of privilege and oppression. We also will be offering trauma sensitive approaches to the Work and to better serve you we would benefit from knowing if there are participants who have been impacted by traumatic experiences and ongoing stresses.   This information will help us to better plan for our time together and p we hope it will be a meaningful reflection for you on some of the circumstances of your life. Please respond with what feels accurate at this time in your life. This will only be shared with the Facilitation Team.

This information will be kept confidential among the facilitation team.  During our time together you will be invited to share only what you feel comfortable sharing with others. It is also optional as to whether you provide your name or not. If you would like this to be anonymous, that is just fine. Thank you and with anticipation of this time together!
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Name
What would you most appreciate learning in this retreat? What would best support you?
Do you identify as a person with a disability - either physical or mental? Please let us know any specific needs you would like us to be aware of.
Has your disability caused you to experience ableism, trauma and/or ongoing stress? How? How has your disability been an advantage to you?
What is your racial identity?  Where are your ancestors were from? What was your first language?  
Has your racial identity caused you to experience racism, trauma and/or ongoing oppression? How? How as your racial identity been an advantage?
What gender pronouns do you prefer?
Clear selection
Sexual orientation
Clear selection
Has your gender identification caused you to experience sexism or genderism, traumatic experiences and/or ongoing stresses? How? How has your gender identity been an advantage?
Age
Clear selection
Have you experienced ageism or oppression or marginalization based on your age? How? How as your age been a benefit to you?
What, if any, is your religious affiliation and/or spiritual orientation and practices.
Due to your religions affiliation or practices have you experienced oppression, marginalization or traumatic experiences? How? How has your religious affiliation been an asset to you?
What is your current socioeconomic situation? (Although class also includes factors like education and inherited wealth, The Pew Research Center can give you a beginning reference point based on current income in the USA. http://www.pewresearch.org/fact-tank/2016/05/11/are-you-in-the-american-middle-class/)
Clear selection
Was your childhood socioeconomic situation similar or substantially different from your current situation? (note: income figures in the above question are relative to 2014, so this question is more qualitative than quantitative).
Educational experience & degrees completed - check all that apply
Have you experienced classism or oppressions based on your class? How?  How as your class been an advantage to you?
Profession or current work and passions
What do you do for fun? To be creative? To play?
Do you have access to the natural world? How much time to you spend outdoors?
What does nature connection mean to you?
Are there areas of your life, not mentioned above, where you consider yourself to have been oppressed or marginalized or given special consideration.
Have you participated in Anti-Racism / Anti-oppression trainings? If so what trainings and would you recommend them to others?
Did any of the above questions bring up an emotional reaction, resistance or particular sensitivity?
Do you wish to elaborate on any of the above questions or speak to an area of your identity that is important to you that was not mentioned?
In your area/region/ country who do you perceive as privileged, who as marginalized, and who as oppressed?
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