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Roger Williams Park Zoo Discussion with our Closest Neighbors
Thank you for your interest in helping the Roger Williams Park Zoo better serve our community and expand our impact and programming! Your participation will help us better understand the strengths and resources in your community and shape the future of the Zoo. The purpose of the questionnaire is to collect basic information from local neighborhood residents who are interested in joining a discussion with the Zoo regarding the future of our programming and how it could benefit the local community.
Answering the following set of questions takes approximately 5 minutes.
By completing this form, you will provide basic information and indicate your interest in attending a virtual discussion or completing a survey. While some answers are required for registration, you may choose not to answer any or all of these questions. Your responses will be confidential and contained within the organization. Your answers will be used for official Roger Williams Park Zoo program development only and your contact information will not be shared beyond the Zoo and our project partner, Antioch University.
Consent
I agree to voluntarily participate
Clicking the “agree” button indicates the following: you have read the above information, you voluntarily agree to participate, and you are at least 18 years of age.
Name
(Required)
First
Last
Phone
In case we need to contact you about your submission.
Primary Email
(Required)
Enter Email
Confirm Email
Winners will be contacted by email.
Your Age (must be 18 or older)
(Required)
18-24
25-34
45-54
55-64
65 and older
What gender do you most identify with?
Male
Female
Non-Binary
None of these
Prefer not to say
(Please select all that apply)
Are you of Hispanic, Latino, or Spanish origin?
(Required)
Yes
No
If yes, please specify
Which do you identify with?
Black, African American
Native American or Alaska Native
Asia
Native Hawaiian or other Pacific Islander
White / Caucasian
Other
(Please select all that apply)
If you answered other, please specify
Your Household Income
(Required)
> $26,000
$26,000 – $50,000
< $50,000
Your Providence Neighborhood
(Required)
Upper South Providence
Lower South Providence
Charles
Wanskuck
Downtown
Federall Hill
Onleyville
Elmwood
South Elmwood
West End
Washington Park
Silver Lake
Manton
Mt. Hope
Hope
Mt. Pleasant
Reservoir
Hartford
Fox Point
Valley
Blackstone
Elmhurst
College Hill
Wayland
Smith Hill
Your Zip Code
(Required)
ZIP / Postal Code
Please choose how you would like to participate.
Participating in a virtual discussion group if space is available. ( A computer and internet connection are required. Discussion group participants will receive $25 VISA gift card). I understand that I will have the opportunity to participate through a survey if discussion groups are full.
I would like to participate through a survey. ( Survey participants will be entered into a drawing for a $200 VISA gift card)
Please answer the following about your participation in a virtual discussion group.
I will not require reimbursement for childcare if I participate in a virtual discussion group.
I will require reimbursement for childcare if I participate in a virtual discussion group.
Please select your survey preference
I would prefer to complete the survey in English
I would prefer to complete the survey in Spanish
Other
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