We'd love to receive your answers to our "Voices" questionnaire and consider them for publication! If you'd like to read what others have to say before filling out the form, just click here. It is not necessary to answer all of the questions below, but we would like you to complete the entire first section with your background information in it. Before answering the questionnaire, you may want to test the form to be sure that your browser submits the questionnaire properly. Simply do a test by going to the bottom of the questionnaire and submitting a blank form. If your browser is submitting it properly you will see a "thank you" page. Then simply return back to answer the questionnaire. Thank you!
	Your name: Your email address: Would you like your name changed, if published? yes no Age: Occupation: Birthplace: Residence: Mother's Birthplace: Maternal Grandmother's Birthplace: Maternal Grandfather's Birthplace: Father's Birthplace: Paternal Grandmother's Birthplace: Paternal Grandfather's Birthplace: Do you feel that new immigrants to North America should assimilate into the mainstream? Would your parents object to you dating or marrying a person who was of a different race than you? Explain why or why not. What do you think of affirmative action and racial quotas in the workplace? What do you think of signs on businesses that don't have any English on them? Have you ever been discriminated against because of your race or the color of your skin? Tell us about it. Has anything, relating to race, happened lately that really bothered you? What is the most unusual thing you've ever eaten? Where were you when you ate it? What is your favorite "ethnic" food? Where do you live and where have you traveled where the culture was the most different from your own? Do you feel that you are in touch with your culture of origin? Please explain. Have you ever traveled back to the homeland(s) of your ancestors? Why not, if you haven't? What percentage of your friends are able to speak a language other than English? In brief, describe your idea of a perfect world. Do you or did you ever wish that you were of another race? Why or why not? Do you feel uncomfortable if you are a minority in a room full of people who are all of one race? Are you physically attracted to people of a different race? If so, why do you think you are? If not, then why not? How did you feel about responding to this questionnaire? Thank you for taking the time to answer our questionnaire. Please come back and visit to see if your answers are published in one of our issues! Responding to the questionnaire does not necessarily mean that your answers will be published. Responses chosen for publication may be edited for clarity. All submissions become property of Urban Mozaik Magazine. This website: Copyright © 2000, 2001, 2002, 2003, 2004, 2005 Dream World Media / Urban Mozaik Magazine. All rights reserved. This website/publication, in whole or in part, may not be reproduced without written permission from the publisher or the previous publisher of original republished materials.