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Human Relations Community Survey

  1. The Hutchinson Human Relations Commission invites you to complete the following survey in order to know to what extent residents or visitors perceive the existence of discrimination in our community. We ask that you only complete this survey once, whether that be online or paper form. Submissions will be accepted through December 20, 2019.

  2. Gender*

  3. Are you a person with a disability?*

  4. Do you identify as a member of the LGBTQ Community?*

  5. Age*

  6. Religious Affiliation*

  7. Race/Ethnicity*

  8. Residency*

  9. Employment*

  10. Do you believe discrimination exists in Hutchinson?*

  11. Have you been a witness and/or has discrimination happened to you in Hutchinson?*

    Click all that apply.

  12. If so, how recently?*

  13. Where were you and/or the victim discriminated against?*

    Check all that apply.

  14. What was the basis of the discriminatory act?*

    Check all that apply.

  15. If you were discriminated against, what action did you take?*

  16. If you took no action, tell us why:*

  17. If you would like to receive information from the Human Relations Commission in the future, please feel free to provide your email.

  18. Leave This Blank:

  19. This field is not part of the form submission.