One Small Step Participant Matching Questionnaire – WSU Ulrich Museum (2023) One Small Step Participant Matching Questionnaire – WSU Ulrich Museum (2023) One Small Step Participant Matching Questionnaire – deprecated (v 2.0) "*" indicates required fields Get connected with a One Small Step conversation partner who shares your curiosity, even if your beliefs differ. Read our FAQs to learn more. The form usually takes around 5-7 minutes to complete. IMPORTANT: Your details will help us match you and personalize email content. Before your interview, we will share your first name, last initial, and a brief bio with your partner exactly as you submit it here.Let’s get started!Name* First Last Email Address* Location (City, State, ZIP)* City ALAKASAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPAPRRISCSDTNTXUTVIVTVAWAWVWIWYAAAEAP State ZIP Code Preferred phone number*One Small Step Connect is our new platform, currently in beta testing, to bridge political divides regardless of where you live. If you opt in to OSS Connect, the following information will be shared with potential participants exactly as you submit in this questionnaire: first name, city & state, gender, age range (e.g., 20–30), political party, social issues score, interests, bio, key descriptors and life events.How did you find out about the opportunity to participate in StoryCorps' One Small Step?* I saw an advertisement (Facebook ad, radio ad, door hanger, poster, etc.) I heard about it at an event I learned about it from a friend, family member, or colleague I heard about it from a group or an organization I’m a part of Another way What is your role/connection to the campus community?* Student Faculty Staff Alumni Other What division do you work for?* Public Safety Dining Services Mail Services Other Are you an ROTC cadet?* Yes No What year did you graduate?Please enter a number from 1900 to 2040.How do you prefer to participate in a One Small Step conversation?VirtuallyIn-personNo preferenceWe only offer a select number of in-person recordings and it may take longer for those opportunities. In person interviews will take place on the Vanderbilt campus.In person interviews will take place on the Dartmouth campus.This field is hidden when viewing the formDo you have access to a computer or mobile device (iPad, tablet, etc.) and reliable internet? Yes No If not, don’t worry! We want to make this opportunity available to everyone, so we will work with you to find another way to participate.Politics & Beliefs Help us understand your beliefs around politics, religion, and more. This information will be used to match you with others whose beliefs differ from yours.Drag the slider to where you see yourself on the scale, with the left being the most liberal and the right the most conservative.How often do you engage in conversations with people who have different beliefs than you? Often Sometimes Rarely Never Where on this scale would you place your thinking on social issues? * I prefer not to place myself on this scale.Briefly describe your thinking on social issues.Where on this scale would you place your thinking on economic issues? * I prefer not to place myself on this scale.Briefly describe your thinking on economic issues.How important is religion in your life? *I prefer not to place myself on this scale. I prefer not to place myself on this scale Briefly describe the role of religion in your life.Are you a registered voter in the US?* Yes No Prefer not to answer Which party are you registered with, if any? Democratic Republican Green American Independent Libertarian No party affiliation/independent Another party Please specifyLife Events & Interests While One Small Step pairs strangers with different beliefs, the goal is to remind us that we’re all human and that we have more in common than we think. The following questions will help us pair you with others who share similar passions or life experiences.Do any of these describe you?Please select as many as you like. Grandparent Parent Political Veteran / From military family Active in my community Outdoorsy / Nature lover Outgoing Animal lover Religious / Spiritual Shy Tech-savvy Creative Have you experienced any of these life events recently?Please select as many as you like. Became a parent Became a grandparent Lost a loved one Moved to a new community Started a new job Lost a job Got married Got divorced / Had a breakup Fought with family or friends over politics Another major event Please describeList up to three (3) additional passions or interests (i.e., hobbies, sports/sports teams, music etc.)Bio & DemographicsProviding the demographic information we ask for below is optional. Having more information about you will help us match you with an interview partner, so we encourage you to provide as much information as you are comfortable sharing.Introduce Yourself*Introduce yourself with a concise bio sharing who you are and your background: family, community, significant life events, personal values, and important issues. Avoid sharing personally identifiable information like your full name or employer. This bio will be read aloud at the beginning of your recorded conversation.Example: I am the youngest of 6 kids and was raised on a farm in rural California. My faith as a Christian drives my politics. Hunting and fishing are important to me, and I care deeply about public land use and conservation. I have been married for 47 years. I have adult children and 6 grandchildren. I lost one of my children a few years ago.Age*Gender Female / Woman Male / Man Another gender identity Please specifyRace / Ethnicity American Indian or Alaska Native Asian Black or African American Hispanic or Latino/a/x Native Hawaiian or Pacific Islander White/Caucasian Not listed above Please specifyReligious affiliation Buddhist Christian Hindu Jewish Muslim Secular/Atheist/Agnostic Unitarian Universalist Not listed above Please specifyMajor:Minor / Concentration:Where is home for you? (city or town):How would you describe your regional background? (e.g. urban, rural, suburban, small town):How would you describe your economic background (e.g. working class, lower-middle class, upper-middle class, upper class, owning class, etc)?:Are you a federal Pell Grant recipient? Yes No To what extent are you involved in these activities in campus?Please select as many as you like.Greek Life Yes No If Yes, which organization?Athletics Yes No If Yes, which sport?Faith-based group Yes No If Yes, which one?Political organization Yes No If Yes, which one?Other group Yes No If Yes, which one?What is one way you feel different from the “typical” Dartmouth student?You’ve reached the end!Once you submit, our team will begin looking for a conversation partner. This thoughtful process takes time, so we appreciate your patience. If you are matched, we will email you with further instructions on scheduling.Untitled First Choice Second Choice Third Choice CommentsThis field is for validation purposes and should be left unchanged.
