The Reformist Pipeline Black History Month Survey

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

The Reformist Pipeline Black History Month Survey

Thank you for taking the time to take our survey. We invite you to complete the survey as many times as you would like so we can hear about some of your most memorable Black History Month experiences. We look forward to receiving your responses!

Sign in to Google to save your progress. Learn more

* Indicates required question

Name *

Your answer

Would you like to be anonymous? *

Yes

No

What were some of your most memorable childhood experiences from Black History Month? If you have another story, please proceed to the next question. *

Your answer

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