Submitted by beau on Tue, 02/14/2023 - 11:46 1 Start 2 Complete First Name Last Name Street Address City Postal Code State/Province Phone Number Email Race or Ethnicity Indigenous Asian Black or African American Latine/Latinx Native Hawaiian or Other Pacific Islander White Arab Jewish Muslim Christian Hindu Agnostic Atheist Other Please check all that apply Are you a resident of Durham? * Yes No Do you have reliable transportation? * Yes No Do you require childcare? * Yes No If so, how many children? Do you have any dietary restrictions/allergies? * Do you have any disabilities, impairments or access needs that you need accommodations for? Are you currently involved in any community groups? If so, please share: Organization Have you or someone you know been affected by harm, violence, policing, or the criminal justice system? If so, can you tell us more? Can we send you texts messages? By entering your phone number and checking this box you are subscribing to receive mobile alerts from Durham Beyond Policing. Yes No Submit
