I may begin distributing this Wednesday, January 29. If you have any suggested changes or words of encouragement, that would be appreciated. And if you think it’s a bad idea, please let me know that as well.
Thanks,
Wade
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NOTE: The questions will be followed by:
___Yes ___No ___Not sure Comments:
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The Personal, the Social, and the Political: A Survey
(1/25/13 Draft)
Introduction
This 14-question survey is intended to explore attitudes and activities concerning personal growth, community development, and political action.
The questions only ask for yes-or-no answers. Completing the survey will probably take less than five minutes.
Responses will be kept anonymous unless otherwise indicated.
A report on the results will be shared with all respondents who ask to receive it.
Respondents will be invited to participate in an online discussion and/or video call about the results.
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The Survey
MUTUAL SUPPORT
Do you have close friends with whom you:
• Feel free to be yourself
• Have fun
• Express deep feelings
• Listen carefully
• Give and receive support
• Get to know each other
• Share happiness
• Discuss the meaning of life
• Evaluate what’s right and what’s wrong
• Help each other become better human beings
• And consider how to improve governmental policies and social institutions?
If you do not have those kind of close friends, would you like to?
If you do have those kind of close friends, do you occasionally gather as a group to engage in those kind of activities together?
PERSONAL GROWTH
In the last month, have you, in one way or another, tried to become a better human being?
During the next month, do you plan to try to become a better human being?
COMMUNITY DEVELOPMENT
In the last month, have you tried to help improve a social institution (or organization), such as a spiritual community, your child’s school, a neighborhood center, or an informal community of friends?
During the next month, do you plan to help improve a social institution or informal community?
POLITICAL ACTION
In the last month, have you engaged in an effort to impact public policy?
During the next month, do you plan to engage in an effort to impact public policy?
FOLLOW-UP
Would you be interested in participating in an online discussion and/or a video call about these questions with others who answer this survey?
If you don’t already, would you like to gather at least once a month with close, trusted friends to share a meal, socialize informally, and hear what others have to say about the kind of questions posed in this survey?
Will you tell others about this survey?
May we identify you as the author of your comments?
Would you like to receive a report on the results of this survey?
Name / Email (we won’t share your email address)