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Demographic Assessment for Communities, Boards, Workgroups, and Councils, F-02870 (08/2021)

Step One

This assessment is a tool to help your group better incorporate voices from diverse communities. The assessment can be completed individually or as a group.

If you choose to complete the assessment as a group, consider whether all present may be equally comfortable speaking. In addition, you should send a hard copy of this assessment to all participants prior to convening, so participants have time to think through responses individually.

1. Consider the population you aim to serve. Are they represented?
Space Cell We have representation on our team.We have representation in other ways (e.g., focus groups, etc).We need representation.We do not serve this population.
Geographic (e.g., statewide, regional, county, local)
Race and Ethnicity (e.g., Asian/Pacific Islander, Black, Caucasian, Hispanic/Latino, Native American)
Sexual Orientation (e.g., heterosexual, lesbian, gay, bisexual, questioning)
Disability (e.g., physical/medical condition, intellectual or developmental disability, emotional/behavioral disorder)
Socioeconomic Status (e.g., below poverty limit, at poverty limit, above poverty limit, well above poverty limit)
Religion (e.g., Christianity, Judaism, Islam, Hinduism, Buddhism, no religious affiliation)
Family Status (e.g., single, married, with or without children)
Language (e.g., English, Spanish, Hmong)
Gender (e.g., male, female, non-binary, transgender, gender queer, gender fluid)
Age (e.g., children, youth, young adults, adults, middle aged, older adults)
Education (e.g., no high school diploma, high school diploma, some college, associate’s degree, bachelor’s degree or above)