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2017 DSCC Affirmative Action Survey

 

The information you provide is strictly confidential.  Other than gender, we will not release information on a particular delegate.  We need this information to be able to track the Party’s performance in terms of our Affirmative Action goals.  As Democrats, we strive to be inclusive and reflective of our society. With accurate information from these forms, we can track our progress in this area.  Thank you.

1. Contact Information

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Name:

 

 

 

 

       

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City/State/ZIP:

 

    

 

Date of Birth:

 

If you respond and have not already registered, you will receive periodic updates and communications from California Democratic Party.


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Question - Not Required - Gender


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Question - Not Required - Please choose the category which best fits your annual income:










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Question - Not Required - Race (check all that apply)
Please make up to 7 selections from the choices below.

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Question - Not Required - Latino subsets
Please make up to 3 selections from the choices below.

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Question - Not Required - Asian Subsets
Please make up to 10 selections from the choices below.

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   Please leave this field empty