You're invited to dream with us!
1.
Please tell us who you are and how we can contact you!

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

 Are there ideas, hopes, or aspirations you have for the center? Please share!

 

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3.

What are you curious to learn more about as the planning of the center continues over the coming months?

 

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4.

What resources or tools would be helpful when you consider your own racial healing?


 

 

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5.

Would you like to engage in any part of the planning process moving forward? If yes, please select the ways you would like to participate (check as many as apply)!

Surveys
Interviews
Focus group conversations
Listening circles
Program testing
6.
Knowing who you are and how you identify will be helpful as we continue to plan for the future. Please self identify however you feel comfortable.
 

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7.

What else would you like us to know?

 

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8.
Are you interested in receiving more information and updates on the Penumbra Center for Racial Healing? 
Yes
No