Appendix 1

List organizations to which you belong.

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List organizations to which your family members belong.

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List organizations with which you and the organizations you belong to have worked.

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List your demographics:

Age _____

Gender _________________

Income _________________

Race ___________________

Family status ______________________________________________________

Religion/spiritual path ______________________________________________

Profession ________________________________________________________

Area of town in which you live ________________________________________

Schools in your area:

Elementary ____________________________________________________

Junior High ____________________________________________________

Senior High ____________________________________________________

Private Schools _________________________________________________

Community Colleges _____________________________________________

Training Institutes _______________________________________________

Universities ____________________________________________________

List your key values: ________________________________________________________________________

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List groups that might share these values (that are not listed above):

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List possible endorsers (both individuals and organizations):

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