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VOICE on the GO
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1
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4
25%
Your Demographics
This information is anonymous but is vitally important in making sure we are reaching ALL people in the region! Help us by providing the following info:
Organization(s)
If you are part of multiple organizations, please indicate each and separate them with commas.
County of Residence
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Gibson
Henderson
Posey
Vanderburgh
Warrick
Prefer not to answer
Your Zip code:
What is your age?
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12 or under
13-18
19-22
23-30
31-49
50-64
65-74
75 and over
Prefer not to disclose
What is your gender?
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Female
Male
Transgender Female
Transgender Male
Non-Binary/Non-Conforming/Non-Directional
Prefer not to answer
What is your race/ethnicity?
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African American/Black
Asian American
Indian (South Asian)
Latino/a/x or Hispanic
Middle Eastern
Native American
Native Hawaiian or Pacific Islander
White/Caucasian
More than one ethnicity
Other
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What is your marital status?
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Married
Domestic Partnership
Divorced
Separated
Widowed
Never Married
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Have you or anyone in your household served on active duty in the U.S. Armed Forces, Reserves, or National Guard?
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Yes
No
Prefer not to answer
Do you or someone in your household have a physical or cognitive disability, either visible or not? (Please check any that apply)
Yes, I have a disability
Yes, someone in my household has a disability
No
Prefer not to answer
Do you or anyone in your household identify as LGBTQA+?
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Yes
No
Prefer not to answer
How would the area you live in be described?
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Urban
Suburban
Rural
What is the highest degree or level of school COMPLETED?
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No High School diploma
Regular High School diploma
GED or alternative credential
Some college
Associate's Degree
Professional Trade School/Certification/License
Bachelor's Degree
Master's Degree
Doctorate Degree
Other
Prefer not to answer
Which best describes the sector in which you are currently or were most recently employed?
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Agriculture
Arts and Entertainment
Communications/Marketing
Construction
Education
Financial Services
Government/Public Service
Health/Medical
Hi-Tech
Hospitality/Food Industry
Law Enforcement
Legal
Manufacturing
Media
Military
Mining/Petroleum
Nonprofit
Professional Services
Renewable Energy
Retail Trade
Social Services
Transportation
Utilities
Wholesale Trade
Other
Prefer not to answer
Including yourself, how many people live in your household?
Select
1
2
3 to 5
6 to 8
More than 8
What is your total estimated household income?
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Under $12,500
$12,500-24,000
$24,001-32,500
$32,501-52,000
$52,501-65,000
$65,001-78,000
$78,001-130,000
Over $130,000
Prefer not to answer
Do you have access to the internet in your household?
Select
Yes
No
Prefer not to answer
What form of transportation do you normally use?
Personal vehicle
Motorcycle
Bicycle/Scooter
Taxi, Uber, Lyft, etc.
Walk
Public Transportation/Bus
Rely on relatives/friends
Prefer not to answer
Do you own or rent your residence?
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Own
Rent
Living with Relatives/Friends
Prefer not to answer
Describe your current housing:
Select
House
Apartment
Condo or Townhome
Boarding
Homeless
Prefer not to answer
Your Neighborhood
What neighborhood to do you live in? Leave blank if you don't know.
Your Passions
What are you passionate about or do you feel positive about in our region? List one or two short answers. For example, "healthcare" and "food security"
Passion #1
Passion #2
Carry Forward/Leave Behind
Given the history of our region (both good and unfortunate), what is good or positive in our region that you would want to carry forward to our preferred future, and what aspects would you want to leave behind? Use one- to two-word answers for each. Examples: Carry Forward "trails" and "collaboration," Leave Behind "divisiveness" and "prejudice."
Carry Forward #1
Carry Forward #2
Leave Behind #1
Leave Behind #2
Your Preferred Future
Now please take a moment to imagine our five-county region* or a specific community that you live or work 15 to 20 years in the future. Envision, create, and describe the positive changes you want to see. What are youth, young adults, and the elderly doing? What kinds of connectivity, green space, and communications exist? How are the Civic Centers working? Consider: Education, Work, Leisure, Environment, Technology, Healthcare, Diversity, etc.
Describe your preferred future for the Region:
What parts of your vision seem possible now?
In 6 months to 1 year?
In 3 to 5 years?
In 10 years?
Is your vision local or regional?
Local
Regional
Both
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CLOSE
Yes, I'd like to get involved!
Fill out the form below, and we'll be in touch. We look forward to you being a part of the change in our community!
First Name
*
Last Name
*
Email
*
Phone
*
County of Interest
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Select the county or counties in which you want to participate.
Select All
Gibson
Henderson
Posey
Vanderburgh
Warrick
I would like to Volunteer and am interested in the following...
Select as many or as few that interest you.
Architect
Facilitator
Floater
Greeter
Host
Leader
Logistics
Marketing/Communications
Photographer/Videographer
Recorder
Scribe
Set-up/Clean-up Crew
General Volunteer
Message
I would like to...
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Session Date
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Session Location
Based on what you envisioned/heard in the session...
What three ideas stood out or moved you?
Does anything seem possible RIGHT NOW?
Does anything seem possible THIS YEAR?
Does anything seem possible IN SEVERAL YEARS?
Is there anything you forgot to say or came to you later?
Who else should we invite to future sessions?
Did you like the process?
Did you connect with new people or ideas?
How did you hear about today's meeting?
Optional Contact Info
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