30 questions
Is English your first language?
Yes.
No.
Did either of your parents graduate from college?
Yes.
No.
Have you been divorced or impacted by divorce?
Yes.
No.
Have you skipped a meal because there was no food in your house?
Yes.
No.
Do you have visible or invisible disabilities?
Yes.
No.
Did your parents and family encourage you to attend college?
Yes.
No.
Does your family have health insurance?
Yes.
No.
Did you study the culture or history of your ancestors in elementary school?
Yes.
No.
Have you been bullied or made fun of based on something you cannot change? (e.g., your gender, ethnicity, age, sexual orientation)
Yes.
No.
Have you ever been offered a job because of your association with a friend or family member?
Yes.
No.
Have you ever been stopped or questioned by the police because they felt you were suspicious?
Yes.
No.
Have you or your family ever inherited money or property?
Yes.
No.
Have you ever been uncomfortable about a joke or statement you overheard about your race, gender, appearance or sexual orientation but felt unsafe to confront it?
Yes.
No.
Did you take out loans for your education?
Yes.
No.
Were there more than 50 books in your home growing up?
Yes.
No.
Are you a white male?
Yes.
No.
Do you worry about sexual assault when walking alone at night?
Yes.
No.
Do the Band-Aids at mainstream stores blend in with or match your skin tone?
Yes.
No.
Do you work with people you feel are like yourself?
Yes.
No.
Does your household employ help as servants, gardeners, etc.?
Yes.
No.
Would you ever think twice about calling the police when trouble occurs?
Yes.
No.
Can you show affection for your romantic partner in public without fear of ridicule or violence?
Yes.
No.
Were you ever discouraged from an activity because of race, class, ethnicity, gender, disability, or sexual orientation?
Yes.
No.
Have you ever tried to change your appearance, mannerisms, or behavior to fit in more?
Yes.
No.
Has there ever been substance abuse in your household?
Yes.
No.
Do you live in an area with crime and drug activity?
Yes.
No.
Does someone in your household suffer from or has someone suffered from mental illness?
Yes.
No.
Have you been a victim of sexual harassment?
Yes.
No.
Have you ever been asked to speak on behalf of a group of people who share an identity with you?
Yes.
No.
Can you make mistakes and not have people attribute your behavior to flaws in your racial or gender group?
Yes.
No.