Participant Questionnaire (online sessions)

Participant Questionnaire

The ArQuives' Community Ties: Our Future Together Online Community Conversations
The ArQuives: Canada’s LGBTQ2+ Archives is gearing up for an exciting new chapter and we want you to be part of it! With support from Women and Gender Equality Canada, we’ve launched Community Ties: Our Future Together, a community consultation initiative to strengthen our organization and expand our impact across Canada.

In February and March, we conducted in-person community conversations in 12 cities across Canada, and now we’re hoping to reach more folks from around the country through our online national survey and community conversations, and one-on-one interviews that will be scheduled individually with participants.

Please note that spaces and honoraria for our online community conversations and one-on-one interviews are limited. This brief questionnaire is designed to help us prepare for each session. Please share this link with others in your community, especially those from historically marginalized communities.

Thank you for your interest in participating! We will reach out to you soon with more information.

(Cette questionnaire est aussi disponible en français.)
Name*

First nameLast name
Email*
example@example.com
Focus group I'd like to join:*

Thursday, 12 June at 6-7:30 pm EST (in English)Friday, 13 June at 2-3:30 pm EST (in English)Sunday, 15 June at 2-3:30 pm EST (in English)Saturday, 14 June 2-3:30 pm EST (in French)One-on-one interview (to be scheduled individually)
Why are you interested in joining this discussion about The ArQuives?
Please enter the first three letters and digits of your postal code. (Note: This question is mandatory as it helps us locate geographically where participants are from.)*

I have no fixed address at presentFirst three characters of your postal code:
What is your gender? Please select all that apply.

ManWomanIntersexNonbinary (including genderqueer and genderfluid)Two-SpiritPrefer not to discloseOther
Are you transgender? (Note: Following historian Susan Stryker, a transgender person is someone who moves away from the gender they were assigned at birth, regardless of destination or mode of transition.)

YesNoPrefer not to disclose
What is your sexual identity? Please select all that apply.

AromanticAsexualBisexualFluidGayLesbianPansexualQueerQuestioning or unsureSame-gender-lovingStraight (heterosexual)Prefer not to discloseOther
Into which age category do you fall?

18 - 29 years30 - 39 years40 - 49 years50 - 59 years60 - 69 years70 years and olderPrefer not to disclose
Including yourself, how many adults (18+) live in your household?
How many children (under 18) live in your household?
Are you a caregiver? (Note: Here "caregiver" is defined care support for a person who is ill or injured, or a parent or guardian of a child under 18 years of age.)

YesNoPrefer not to disclose
What is your approximate annual household income before taxes?

Less than $20,000$21,000 - $40,000$41,000 - $60,000$61,000 - $80,000$81,000 - $100,000$101,000 - $120,000More than $120,000Prefer not to disclose
Are you a person with a disability? (Note: Statistics Canada defines a person with a disability as someone “whose daily activities are limited as a result of an impairment or difficulty with particular tasks.”)

YesNoPrefer not to disclose
Race/ethnicity (Note: Please select one or more categories from the list provided and/or provide a specific response in the “Other” box.)

Indigenous (e.g. First Nations, Inuit, Métis)East Asian (e.g. Chinese, Korean, Japanese, Taiwanese descent)Black (e.g. African, Afro-Caribbean, African-Canadian descent)Latino (e.g. Latin American, Hispanic descent)Middle Eastern (e.g. Arab, Persian, West Asian descent [e.g. Afghan, Egyptian, Iranian, etc.])South Asian (e.g. East Indian, Pakistani, Sri Lankan, Indo-Caribbean, etc.)Southeast Asian (e.g. Filipino, Vietnamese, Cambodian, Thai, etc.)White (e.g. European descent)Prefer not to discloseOther
Do you identify as a newcomer to Canada? (Note: Here “newcomer” is defined as a permanent resident, refugee, or temporary resident [including student, worker, or temporary resident permit holders] who arrived in Canada within the last five years.)

YesNoPrefer not to disclose
Do you consent to being recorded? (Note: Sessions will be recorded for internal use and will be reviewed by our consultants to generate ideas for ArQuives programming, fund raising, and other related matters. Recordings will not be made public but will be a part of our archival records.)*

YesNo
If you would like to remain anonymous and for your photo not to be taken and shared publicly (including but not limited to social media, newsletter, website, annual reports, and educational materials), please check the following boxes:

I do not consent to my name being used in the reporting and promotion of the community conversation.I do not consent to my photograph being used in the reporting and promotion of the community conversation.
Zoom's automated captioning will be enabled. Are there any additional accessibility needs we need to accommodate?
Would you like to be considered for an honorarium ($20)? (Note: Honoraria are available for community members for whom attending is not part of their professional duties.)*

Yes, I would like to be consideredI would like to opt out of the honorarium
Email address to receive the honorarium. (Note: If you do not do online banking, please email Nico Mara-McKay at projectcoordinator@arquives.ca to set up another way to receive it.)
example@example.com
Would you like to be added to our Community Ties newsletter and our general ArQuives newsletter to keep up to date with the project and upcoming activities?

Community Ties newsletterThe ArQuives’ newsletter
Other comments or questions
Should be Empty: