Request edit access
What Holds a Community Together?
We offer you the opportunity to express your opinion about the community you live in. Thus, you help us implement togetherness and social integration.  This survey is confidential and none of the information you enter will be shared with other entities.
Sign in to Google to save your progress. Learn more
 First Name *
Last Name
Email: *
Telephone # *
What is your ethnicity?
Clear selection
Do you feel integrated in the community you live in? *
Explain shortly Why Do You or Why Don't You feel integrated? *
How does your community help you?
Who do you want to get together with? *
Who do you care about? *
Who do you want to help? *
What is the change your community needs the most? *
What are the problems you encounter in your community? *
How do you suggest to solve those problems?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy