Personal Diversity Index

1
Language: Do you speak English fluently and without an accent?* This field is required.
Yes
I speak fluently but with an accent
I do not speak fluently
I think this is irrelevant for my personal diversity score
2
Gender: To which of the following gender identity do you most identify?* This field is required.
Male
Female
Trans
Non binary
I think this is irrelevant for my personal diversity score
3
Sexuality: Are you heterosexual?* This field is required.
YESNO
4
Ethnicity: Which category best describes you?* This field is required.
Asian (Eg: Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc)
Black or African American (Eg: African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, etc)
Hispanic, Latino or Spanish origin (Eg: Mexican or Mexican American, Puerto Rican, Cuban, Salvadoran,Dominican, Colombian, etc)
Middle Eastern or North African (Eg: Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, etc)
American Indian or Alaska Native (Eg: Navajo nation, Blackfeet tribe, Mayan, Aztec, Native Village or Barrow Inupiat Traditional Government, Nome Eskimo Community, etc)
Native Hawaiian or Other Pacific Islander (Eg: Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, etc)
White (Eg: German, Irish, English, Italian, Polish, French, etc)
Some other race, ethnicity or origin
5
Disability: Do you have any disabilities?* This field is required.
No
Yes, and it highly impacts my employment
Yes, but it has a moderate impact on my employment
Yes, but it has little or no impact on my employment
6
Wealth: Which of the following best describe the environment where you grow up?* This field is required.
High income
Comfortable income
Middle class
Low income
Poor
7
Religion: What religious family do you belong to or identify yourself most close to?* This field is required.
Asian Folk Religion
Hindu
Jewish
Muslim
Christian (Catholic protestant or any other Christian denominations)
Other
No religion
8
Age: How old are you?* This field is required.
Less than 21
Between 21 and 40
Between 41 and 55
Between 56 and 65
Above 65
9
Body: How does your body shape or style make you feel in the workplace?* This field is required.
Fine
Generally fine, but there are cases where I feel like I don't fit
I often feel judged negatively because of my body shape
This is a constant challenge for me
10
Values: Do you feel respected about your opinions in the workplace?* This field is required.
Generally yes
No, I often feel like an outsider
No, I feel unwelcome because of my different perspective
11
Is there another reason not already covered that makes you feel different in the workplace?* This field is required.
No
Yes, but it does not really affect me
Yes, and it makes my work much harder
12
Would you please let us know which other aspect of your identity not already covered makes you feel different in the workplace?
13
Can you rate how each of the following identity characteristics discussed above impact how one is perceived in a group?
Not at all
Somewhat
Significantly
Extremely
Language (fluency with no accent)
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Gender
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Sexuality
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Ethnicity
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Disability
Row 4, Column 0
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Wealth (at birth)
Row 5, Column 0
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Religion
Row 6, Column 0
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Age
Row 7, Column 0
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Body (shape)
Row 8, Column 0
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Values (opinion)
Row 9, Column 0
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Language (fluency with no accent)
Gender
Sexuality
Ethnicity
Disability
Wealth (at birth)
Religion
Age
Body (shape)
Values (opinion)
Not at all
Row 0, Column 0
Somewhat
Row 0, Column 1
Significantly
Row 0, Column 2
Extremely
Row 0, Column 3
Not at all
Row 1, Column 0
Somewhat
Row 1, Column 1
Significantly
Row 1, Column 2
Extremely
Row 1, Column 3
Not at all
Row 2, Column 0
Somewhat
Row 2, Column 1
Significantly
Row 2, Column 2
Extremely
Row 2, Column 3
Not at all
Row 3, Column 0
Somewhat
Row 3, Column 1
Significantly
Row 3, Column 2
Extremely
Row 3, Column 3
Not at all
Row 4, Column 0
Somewhat
Row 4, Column 1
Significantly
Row 4, Column 2
Extremely
Row 4, Column 3
Not at all
Row 5, Column 0
Somewhat
Row 5, Column 1
Significantly
Row 5, Column 2
Extremely
Row 5, Column 3
Not at all
Row 6, Column 0
Somewhat
Row 6, Column 1
Significantly
Row 6, Column 2
Extremely
Row 6, Column 3
Not at all
Row 7, Column 0
Somewhat
Row 7, Column 1
Significantly
Row 7, Column 2
Extremely
Row 7, Column 3
Not at all
Row 8, Column 0
Somewhat
Row 8, Column 1
Significantly
Row 8, Column 2
Extremely
Row 8, Column 3
Not at all
Row 9, Column 0
Somewhat
Row 9, Column 1
Significantly
Row 9, Column 2
Extremely
Row 9, Column 3
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14
Your Personal Diversity Score is (0-100):
Should be Empty: