JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
About You
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Are you...
*
please respond thinking primarily about the reason for your visit to the website today
A student or researcher interested in learning about community organizing?
A volunteer leader or staff of a Gamaliel affiliate?
Interested in training or our racial or economic justice campaign work?
A current or prospective funder or donor
Learning about Gamaliel for work or school?
A journalist?
Required
If none of the above describes your reason for visiting our website, how would you describe it?
Your answer
Please tell us your age group?
Born 1994-2003
Born 1981-1993
Born 1963-1980
Born 1946-1962
Born 1925-1945
Please tell us your gender
Male
Female
Transgendered
Please tell us your ethnicity
African American
Arab American
Asian American
European American/Caucasion
Latino
Native American
Multi/Bi-racial
Other:
Please tell us where you are physically located
If you are outside the U.S. please enter your country in Other
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other:
Next
Page 1 of 2
Clear form
Never submit passwords through Google Forms.
This form was created inside of Gamaliel Network.
Report Abuse
Forms
