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WE CAN Network Pulse Check

Questions marked with a * are required

Confirm the BEST EMAIL address to reach you

What is your racial/ethnic identity?

American Indian or Alaska Native: Individuals with origins in any of the original peoples of North, Central, and South America, including, for example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, and Maya.

Asian: Individuals with origins in any of the original peoples of Central or East Asia, Southeast Asia, or South Asia, including, for example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese.

Black or African American: Individuals with origins in any of the Black racial groups of Africa, including, for example, African American, Jamaican, Haitian, Nigerian, Ethiopian, and Somali.

Hispanic or Latino: Includes individuals of Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, and other Central or South American or Spanish culture or origin.

Middle Eastern or North African: Individuals with origins in any of the original peoples of the Middle East or North Africa, including, for example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, and Israeli.

Native Hawaiian or Pacific Islander: Individuals with origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands, including, for example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, and Marshallese.

White: Individuals with origins in any of the original peoples of Europe, including, for example, English, German, Irish, Italian, Polish, and Scottish.

Multi-racial: One or more of the above referenced racial/ethnic groups

What state do you live in?

What is the MOST IMPORTANT issue/outcome to you?

We have access to quality HEALTH AND WELLNESS supports

We have the opportunity for ECONOMIC SECURITY

We are SAFE in our homes and communities

We are WELL REPRESENTED BY OUR ELECTED OFFICIALS and other leaders

Other

How can WE CAN help you get involved (if you decide to engage)?

Sponsor health and wellness events

Convene in-person local action-focused meetings

Provide virtual civic engagement training

Provide an online community for information and action

Other

Is there anything else you would like to share with WE CAN?