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40
Questions
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1
Organization Name
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2
Name
First Name
Last Name
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3
Email
example@example.com
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4
Phone Number
Area Code
Phone Number
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5
Preferred language
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6
Gender identify
Woman
Man
Gender Fluid
Non-Binary
Trans Man
Trans Women
I'd rather not say
Other
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7
Sexual Orientation
Asexual
Bisexual
Homosexual
Heterosexual
Pansexual
Queer
I'd rather not say
Other
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8
Do you identify with the disability community?
Yes, I have a disability
No, I do not have a disability
I previously had a disability
I'd rather not say
Other
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9
Which categories best describe you?
Asian (e.g., Chinese, Filipino, Asian Indian, Vietnamese, Korean, Japanese, etc.)
Black or African American (e.g., African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian, etc.)
Hispanic or Latine (e.g., Mexican or Mexican American, Puerto Rican, Cuban, Salvadorian, Dominican, Colombian, etc.)
Middle Eastern or North African (e.g., Lebanese, Iranian, Egyptian, Syrian, Moroccan, Algerian, etc.)
Native American or Alaska Native (e.g., Navajo Nation, Blackfeet Tribe, Mayan, Aztec, Nome Eskimo Community, etc.)
Native Hawaiian or other Pacific Islander (e.g., Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.)
White (e.g., German, Irish, English, Italian, Polish, French, etc.)
Other
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10
Justice, Equity, Diversity, and Inclusion are issues that are of real concern to (check all that apply)
Me, personally
Me, professionally
People in my personal network
People, in my extended network
I’m not sure this is a real concern
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11
Job Title
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12
How long have you been with the organization?
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13
Are you part of organizational leadership?
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14
Number of people in the department
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15
What are your most pressing JEDI needs?
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16
What are the organization's most pressing JEDI needs?
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17
I have a good understanding on what JEDI is (Justice Equity Diversity and Inclusion)
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Needs Improvement
JEDI Expert
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18
Our organizational mission, vision, and values demonstrate commitment to JEDI
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Needs Improvement
JEDI Expert
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19
Our organization incorporates a Disability Justice lens into the work being done
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Needs Improvement
JEDI Expert
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20
Our organization recognizes and celebrates diverse cultures and religious/spiritual affiliations by considering various religious and cultural holidays when scheduling events and Board meetings ensuring that holiday decor is inclusive
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Needs Improvement
JEDI Expert
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21
Our organization has an employee handbook
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Needs Improvement
JEDI Expert
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22
Our organization has a non-discrimination policy
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Needs Improvement
JEDI Expert
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23
Our organization has a whistleblower policy
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Needs Improvement
JEDI Expert
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24
Our organization has a conflict of interest policy
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Needs Improvement
JEDI Expert
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25
Our organization has a clear onboarding process
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Needs Improvement
JEDI Expert
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26
Our fundraising materials are reflective of diverse donors and program participants
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Needs Improvement
JEDI Expert
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27
I am comfortable reporting any issues to a supervisor, or senior team member regarding any negative treatment or unfair experience
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Not Comfortable
Very Comfortable
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28
Our leadership sets the example in the JEDI work beginning with the board and executive leadership
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Needs Improvement
JEDI Expert
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29
Our organization provides training on JEDI best practices for our board, staff, and volunteers
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Needs Improvement
JEDI Expert
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30
Our board and staff are held accountable for the organization’s established JEDI practices
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Needs Improvement
JEDI Expert
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31
Our board includes: People with Disabilities, people with different racial backgrounds, gender balance, diversity of age groups, representatives of the community served
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Needs Improvement
JEDI Expert
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32
Our current hiring practices effectively incorporate JEDI best practices
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Needs Improvement
JEDI Expert
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33
Our organization requires all staff, leadership, and Board members to participate in Justice, Equity, Diversity, and Inclusion trainings as part of the onboarding process
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Needs Improvement
JEDI Expert
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34
Our organization ensures that employees are given equitable access to professional development opportunities
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Needs Improvement
JEDI Expert
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35
Our offices are clean and welcoming, ADA compliant, and fully accessible to people with disabilities
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JEDI Expert
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36
Members of the community can access our services regardless of race, gender, ethnicity, or disability
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Needs Improvement
JEDI Expert
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37
Our organization is diligent about engaging the public in communities that serve diverse constituencies
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Needs Improvement
JEDI Expert
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38
Our programs and events are accessible to people with disabilities
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Needs Improvement
JEDI Expert
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39
Speakers for our events and people featured in our materials represent different cultural and linguistic backgrounds and are inclusive of people with disabilities
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Needs Improvement
JEDI Expert
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40
Is there anything else you'd like to add?
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