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Do you think Racism is a problem?
 
Yes
 
No
 
 
 
Do you believe that Racism is a problem in your society?
 
Yes
 
No
 
 
 
What race is most affected by racism?
 
Hispanic
 
African American
 
Asian
 
Native American
 
 
 
Do you think that Racism is the biggest problem in our community?
 
Yes
 
No
 
 
 
How often do you witness racism?
 
Always
 
Sometimes
 
Rarely
 
Never
 
 
 
Do you think that there is something that we can do to stop Racism?
 
Yes
 
No
 
 
 
Where does racism occur the most in your community?
 
School
 
Home
 
Work
 
Other
 
 
 
 
Have you ever been affected by Racism?
 
Yes
 
No
 
 
 
Do you believe that Racism is a “Norm” in today's society?
 
Yes
 
No
 
 
 
What is your reaction when you witness someone say a Racial slur or comment?
 
Do Nothing
 
Stand up against them
 
Tell someone who can do something about it.
 
Other
 
 
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