Silverfish Project Representatives Questionnaire
7/1/2024
Name
*
First Name
Last Name
Email (this will be used to contact you)
*
example@example.com
Repeat Email
*
example@example.com
Phone Number (optional)
Please enter a valid phone number.
Format: (000) 000-0000.
List your current occupation
*
(If none, please type N/A)
What demographics/viewpoints do you want to represent?
*
Please provide a one sentence, high level summary of you, your viewpoints, and/or what you want to assist the Silverfish Project with.
*
More details will be shared in the next question.
0/250
In at least 3 or more sentences, please share a summary of what you can offer to the Silverfish Project as we outline foundational documentation to further support the Rebellion?
*
(ex. legal background, healthcare worker, member of at-risk/targeted community, unique personal experience, etc)
0/0
To help us understand and work together with all demographics, please describe your top 3 personality traits/strengths.
*
(You may choose to include details on your awareness on why these are your strengths, including specific situational examples, if desired)
Additionally, please describe your top 3 negative traits/weaknesses.
*
(You may choose to include details on your awareness on why these are your weaknesses, including specific situational examples, if desired)
What else should we know about you? Share at least one unique fact about yourself.
(ex. unique skills, hobbies, knowledge, or experience)
Please list any dates in the next 90 days that you are aware you will not be available to be consulted by us, if selected.
*
I am aware that the Silverfish Project expects all representatives to conduct themselves with respect for all viewpoints. This does NOT mean you need to agree, but it does require that you actively listen and work towards comprehension of complex and varying opinions.
*
I have read and agree to this statement.
I am aware that my viewpoints, perspectives, and experiences CANNOT under any circumstances, threaten, devalue, or jeopardize the safety, security, liberty or livelihood of ANY demographic. The Silverfish Project does not promote or tolerate hatred or disrespect of any kind.
*
I have read and agree to this statement.
Submit
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