Demographic Information
Thank you so much for agreeing to participate to help me understand YOUR story a little better.  I want to work hard to be inclusive and mindful of the various people who come to my page and/or listen to my podcast.  Your answers are anonymous.

I am an ally for people of all races, ethnicities, nationalities, classes, abilities, sizes, shapes, orientations, & placements along the gender spectrum.  I want that to be more than a sentence.  In the real world, I am a 30 year old white American woman.  I can share my story all day long, but I think I am going to be unintentionally miss out on KEY things that I never had to face.

I invite you to help me be sure your story, community, voice, and experiences are represented.  I don’t want this page or podcast to be a white American’s guide to survival.  As this continues to grow, I want to do my homework to be sure I try my absolute hardest to make this a place ANY woman struggling with issues can come to.

Sign in to Google to save your progress. Learn more
What sex were you assigned at birth (i.e., what your birth certificate said)? *
What gender do you currently identify with?  Please select all that apply. *
Required
What do you consider your current sexual orientation?  Please select all that apply. *
Required
Are you of Hispanic, Latino, or of Spanish origin? *
How would you describe yourself?  (Choose all that apply) *
Required
What is our age? *
What is your relationship status? *
Do you currently live with your significant other? *
What is the highest degree or level of school you have completed?  If you are currently enrolled in school, please indicate the highest degree you received. *
What is your current employment status? *
Please state the name of the country & city that you currently live in.
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy