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Discrimination Survey
1) I feel that I need to minimize certain aspects of my racial/ethnic culture such as language, clothing or ways of articulation/interaction in order to be able to “fit in” my community.
Yes
No
Not Sure
2) How often have you seen minorities be asked to speak for their entire race/ethnic group, whether directly or indirectly?
Regularly
Sometimes
Rarely
Never
3) Have you or someone you know ever been stopped or followed by police because of your race/ethnic origin?
yes
No
Not Sure
4) Have you ever been harassed or discriminated against because of your foreign accent or for speaking a language other than English?
yes
No
Not Applicable
5) Have you ever witnessed or been a victim of a hate crime?
Yes
No
6) Have you ever heard or been a target of culturally insensitive jokes, racial epithets, cartoons, graffiti or other similar forms of discrimination?
Yes
Not
Not Sure
7) Do you feel that all-White schools should still teach Black History even if there are no children of color in the school?
Yes
No
Undecided
8) How important is it for you to learn about racial/ethnic groups different from your own?
Very Important
Somewhat Important
Not Very Important
Not Important at all
9) How important is it for you to attend multicultural events?
Very Important
Somewhat Important
Not Very Important
Not Important at all
10) In my community, I can access services that are consistent with my religious preferences.
Yes
No
Not Sure
11) In my community, I can access culturally relevant forms of entertainment.
Yes
No
Not Sure
12) How comfortable are you interacting with someone of a different race/ethnicity?
Very Comfortable
Somewhat Comfortable
Slightly Uncomfortable
Very Uncomfortable
13) If you saw someone nearby being discriminated against, what would you do?
Protest against the perpetrator
Listen In
Nothing
Not Sure
14) How often are stereotypes heard, seen or discussed among you and your friends?
Very Often
Somewhat Often
Rarely
Never
15) Do you believe that discrimination of any type still exists?
Yes
No
Not Sure
16) Define your stance on this phrase: Youth do not witness or understand discrimination.
True
False
17) I am hesitant to confront others on their prejudicial views
Yes
No
18) I am a victim of others’ discrimination.
Yes
No
Not Sure
19) What are the top 3 factors that you believe cause discrimination to exist (choose only 3):
Religious beliefs
Cultural viewpoints
Personal or negative experiences
Family/Friend views
Physical differences
Cultural differences
Ignorance
20) Where did you first learn about discrimination?
Home
School
Religious Setting
Other:
21) What do you remember as being your first experience with discrimination?
22) Do you think this survey has made you think differently or deeply about discrimination?
Yes
No
Other:
23) What is your marital status?
Single
Married
Separated
Divorced
Widowed
Prefer Not To Say
24) What is your age cohort?
Below 21
21-30
31-40
41-50
51 and above
25) What is your gender?
Male
Female
Transgender
26) Please indicate your racial/ethnic origin:
White/European descent
Black/African descent
Hispanic/Latino
Asian descent
Middle-Eastern
Native Hawaiian or Pacific Islander
American Indian/Alaskan Native
Biracial/Multi-racial
Prefer Not To Say
Other:
2012 Multicultural Calendar
Coming Soon!