You can always press Enter⏎ to continue
Feedback Form
We have designed this feedback form to get a better insight into the views of our supporters regarding our communication in order to improve our services. Data collected through this form is anonymous.
10
Questions
START
Language
English (UK)
Nederlands
1
We promise to processed the data you provide in accordance with the European Union’s General Data Protection Regulation.
*
This field is required.
Previous
Next
Submit
Press
Enter
2
In which country are you based?
*
This field is required.
The countries included in the list are the Member and the Permanent Non-member States of the United Nations
Select one of the countries
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia, Plurinational State of)
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde (Cape Verde)
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the (DRC)
Costa Rica
Côte d’Ivoire (Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini, the Kingdom of (Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia, Republic of The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of (North Korea)
Kuwait
Kyrgyzstan
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Republic of Korea (South Korea)
Republic of Moldova
Republic of Congo
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vicent and the Grenadines
Samoa
San Marino
São Tomé and Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Thailand
The former Yugoslavian Republic of Macedonia (FYROM)
The Holy Sea
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United Republic of Tanzania
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of
Viet Nam
Yemen
Zambia
Zimbabwe
Other
Select one of the countries
Select one of the countries
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia, Plurinational State of)
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde (Cape Verde)
Cambodia
Cameroon
Canada
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the (DRC)
Costa Rica
Côte d’Ivoire (Ivory Coast)
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini, the Kingdom of (Swaziland)
Ethiopia
Fiji
Finland
France
Gabon
Gambia, Republic of The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of (North Korea)
Kuwait
Kyrgyzstan
Lao People’s Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Republic of Korea (South Korea)
Republic of Moldova
Republic of Congo
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vicent and the Grenadines
Samoa
San Marino
São Tomé and Príncipe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Thailand
The former Yugoslavian Republic of Macedonia (FYROM)
The Holy Sea
Timor-Leste
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United Republic of Tanzania
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela, Bolivarian Republic of
Viet Nam
Yemen
Zambia
Zimbabwe
Other
Previous
Next
Submit
Press
Enter
3
Please specify your city or village:
*
This field is required.
Previous
Next
Submit
Press
Enter
4
How do you identify your gender?
*
This field is required.
Male
Female
Non-binary
Prefer not to disclose
Previous
Next
Submit
Press
Enter
5
What is your age group?
*
This field is required.
Below 18
18-24
25-34
35-44
45-59
60-74
75+
Previous
Next
Submit
Press
Enter
6
Which of our topics interests you more?
*
This field is required.
You can select more than one topic if you want, and then press next
Human Rights Defenders and Security (Shelter City)
Migration and Human Rights (Samen Hier)
Other Justice and Peace topics (like the Martin Luther King lecture)
Previous
Next
Submit
Press
Enter
7
Do we include enough content in our communications?
*
This field is required.
1 means not enough, 5 means more than enough
1
2
3
4
5
Not enough
More than enough
Previous
Next
Submit
Press
Enter
8
Do we provide you with sufficient information in our communication?
*
This field is required.
YES
NO
Previous
Next
Submit
Press
Enter
9
Please select the answer that reflects your view:
*
This field is required.
Once selected please press next
Completely Disagree
Disagree
Neutral
Agree
Completely Agree
Justice and Peace's communication empowers me to take action
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Justice and Peace's communication empowers me to support their work
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Row 1, Column 3
Row 1, Column 4
Justice and Peace's communication empowers me to take action
Justice and Peace's communication empowers me to support their work
Completely Disagree
Row 0, Column 0
Disagree
Row 0, Column 1
Neutral
Row 0, Column 2
Agree
Row 0, Column 3
Completely Agree
Row 0, Column 4
Completely Disagree
Row 1, Column 0
Disagree
Row 1, Column 1
Neutral
Row 1, Column 2
Agree
Row 1, Column 3
Completely Agree
Row 1, Column 4
1
of 2
Previous
Next
Submit
Press
Enter
10
In which way would you like to support our work?
*
This field is required.
You can select more than one options, and then press next
Become a trainee or volunteer
Become a Samen Hier partner
Become a Shelter City partner
Start a Samen Hier welcome group
Donate to Justice and Peace
Other: share your suggestions in the next slide
Previous
Next
Submit
Press
Enter
11
You can openly share more here or leave your contact information if you would like us to get in touch with you (or press review and submit).
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
Should be Empty:
JPNL
[Edit]
Question Label
1
of
11
See All
Go Back
Submit