pre assessment

master
grgr 1 year ago
parent 2af7ffd8a5
commit 5b7a6fb8c9

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@ -23,6 +41,9 @@ body{
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@ -78,27 +78,33 @@ button:hover{
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/* /////////// PRINT ////////////// */ /* /////////// PRINT ////////////// */
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@ -108,6 +114,12 @@ p{
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@ -40,15 +40,14 @@
<p>PLEASE MARK WITH THE SYMBOLS ⚠️ or 🔥 or 😡 ANY SENSITIVE INFORMATION YOU WISH NOT TO BE PUBLIC. Such information will be held as professional secret.</p> <p>PLEASE MARK WITH THE SYMBOLS ⚠️ or 🔥 or 😡 ANY SENSITIVE INFORMATION YOU WISH NOT TO BE PUBLIC. Such information will be held as professional secret.</p>
<h3>GETTING READY</h3> <h3>GETTING READY</h3>
<p>Find the appropriate time and space for the boiler inspection. You can decide to conduct it together with others that <p>Find the appropriate time and space for the boiler inspection. Ideally, the inspection may be conducted togheter with everyone involved in your organization, but if this is not possible it's ok to do it with fewer people. <br>
Ask not to be disturbed. <br> Ask not to be disturbed. Find a comfortable position, and take a deep breath.
Find a comfortable position, and take a deep breath.
</p> </p>
<p>Now you can turn the page and start the boiler inspection.</p> <p>Now you can turn the page and start the boiler inspection.</p>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
</div> </div>
</div> </div>
@ -61,245 +60,238 @@
<form action=""> <form action="">
<div class="inspection-form">
<h1>Inspection form</h1> <h1>Inspection form</h1>
<br> <br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
<br> <br>
<label for="org_name">name of the organization</label> <label for="org_name">name of the organization</label>
<input type="text" name="org_name"> <input type="text" name="org_name">
<br> <br>
<label for="date">inspected on</label> <label for="date">inspected on</label>
<input type="text" name="date" placeholder="date"> <input type="text" name="date" placeholder="date">
<label for="inspector">by</label> <label for="inspector">by</label>
<input type="text" name="inspector" placeholder="name/alias of the inspector"> <input type="text" name="inspector" placeholder="name/alias of the inspector">
<br> <br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
<h5>1. description of the boiler</h5> <h5>1. description of the boiler</h5>
Age of the organization: <input type="text"> <br><br> Age of the organization: <input type="text"> <br><br>
<label for="org_description">short description of the organization's activity</label> <br> <label for="org_description">short description of the organization's activity</label> <br>
<textarea name="org_description" id="" cols="80" rows="6"></textarea> <textarea name="org_description" id="" cols="60" rows="2"></textarea>
<br> <br>
<br> <br>
The following infrastructural elements are collectively used by the organization for its activities (select multiple): <br> The following infrastructural elements are collectively used by the organization for its activities (select multiple): <br>
<div id="infra-elem"> <div id="infra-elem" style="display: grid; grid-template-columns: 1fr 1fr;">
<div class="inp"><input type="checkbox"> <label for="">meeting/working table</label></div> <div class="inp"><input type="checkbox"> <label for="">meeting/working table</label></div>
<div class="inp"><input type="checkbox"> <label for="">kitchen</label></div> <div class="inp"><input type="checkbox"> <label for="">kitchen</label></div>
<div class="inp"><input type="checkbox"> <label for="">stairs</label></div> <div class="inp"><input type="checkbox"> <label for="">stairs</label></div>
<div class="inp"><input type="checkbox"> <label for="">toilet</label></div> <div class="inp"><input type="checkbox"> <label for="">toilet</label></div>
<div class="inp"><input type="checkbox"> <label for="">couch</label></div> <div class="inp"><input type="checkbox"> <label for="">couch</label></div>
<div class="inp"><input type="checkbox"> <label for="">server</label></div> <div class="inp"><input type="checkbox"> <label for="">server</label></div>
<div class="inp"><input type="checkbox"> <label for="">Internet Relay Chat (IRC)</label></div> <div class="inp"><input type="checkbox"> <label for="">Internet Relay Chat (IRC)</label></div>
<div class="inp"><input type="checkbox"> <label for="">file sharing</label></div> <div class="inp"><input type="checkbox"> <label for="">file sharing</label></div>
<div class="inp"><input type="checkbox"> <label for="">email service</label></div> <div class="inp"><input type="checkbox"> <label for="">email service</label></div>
<div class="inp"><input type="checkbox"> <label for="">cloud</label></div> <div class="inp"><input type="checkbox"> <label for="">cloud</label></div>
<div class="inp"><input type="checkbox"> <label for="">code of conduct</label></div> <div class="inp"><input type="checkbox"> <label for="">code of conduct</label></div>
<div class="inp"><input type="checkbox"> <label for="">working agreements</label></div> <div class="inp"><input type="checkbox"> <label for="">working agreements</label></div>
<div class="inp"><input type="checkbox"> <label for="">insurances</label></div> <div class="inp"><input type="checkbox"> <label for="">insurances</label></div>
<div class="inp"><input type="checkbox"> <label for="">sick pay</label></div> <div class="inp"><input type="checkbox"> <label for="">sick pay</label></div>
<div class="inp"><input type="checkbox"> <label for="">pension</label></div> <div class="inp"><input type="checkbox"> <label for="">pension</label></div>
<div class="inp"><input type="checkbox"> <label for="">bank account</label></div> <div class="inp"><input type="checkbox"> <label for="">bank account</label></div>
<div class="inp"><input type="checkbox"> <label for="">printers</label></div> <div class="inp"><input type="checkbox"> <label for="">printers</label></div>
<div class="inp"><input type="checkbox"> <label for="">3D printer</label></div> <div class="inp"><input type="checkbox"> <label for="">3D printer</label></div>
<div class="inp"><input type="checkbox"> <label for="">DIY tools and software</label></div> <div class="inp"><input type="checkbox"> <label for="">DIY tools and software</label></div>
<div class="inp"><input type="checkbox"> <label for="">social media platform</label></div> <div class="inp"><input type="checkbox"> <label for="">social media platform</label></div>
<div class="inp"><input type="checkbox"> <label for="">API (Application Programming Interface)</label></div> <div class="inp"><input type="checkbox"> <label for="">API (Application Programming Interface)</label></div>
<div class="inp"><input type="checkbox"> <label for="">other electronic components</label></div> <div class="inp"><input type="checkbox"> <label for="">other electronic components</label></div>
<div class="inp"><input type="checkbox"> <label for="">other hosting services</label></div> <div class="inp"><input type="checkbox"> <label for="">hosting services</label></div>
<div class="inp"><input type="checkbox"> <label for="">open source budgeting software</label></div> <div class="inp"><input type="checkbox"> <label for="">open source budgeting software</label></div>
<div class="inp"><input type="checkbox"> <label for="">open source ticketing system</label></div> <div class="inp"><input type="checkbox"> <label for="">open source ticketing system</label></div>
<div class="inp"><input type="checkbox"> <label for="">other open source admin tools</label></div> <div class="inp"><input type="checkbox"> <label for="">other open admin tools</label><input type="text"></div>
<div class="inp"><input type="checkbox"> <label for="">other</label> <input type="text"></div> <div class="inp"><input type="checkbox"> <label for="">other</label> <input type="text"></div>
</div> </div>
<br> <br>
<label for="boiler_img">Map of the boiler: <br> schematic drawing of the overall infrastructure, including the elements above mentioned </label> <label for="boiler_img">Map of the boiler: <br> schematic drawing of the overall infrastructure, including the elements above mentioned </label>
<br><textarea name="boiler_img" id="" cols="50" rows="16"></textarea> <br><textarea name="boiler_img" id="" cols="60" rows="12"></textarea>
<br> <br>
<br> <br>
All the people inside the organization have "equal" access and/or basic knowledge of the infrastructural elements marked above and drawed on the map.<br> All the people inside the organization have "equal" access and/or basic knowledge of the infrastructural elements marked above and drawed on the map.<br>
Write T (true) or F (false) next to their checkboxes and mark them with a cross on the map.<br> Write T (true) or F (false) next to their checkboxes and mark them with a cross on the map.<br>
<br> <br>
<br> <br>
Is the organization ONLY using FLOSS (Free Open Source) software for their activities? <br> Is the organization ONLY using FLOSS (Free Open Source) software for their activities? <br>
<input type="radio" name="" id=""> yes <input type="radio">yes, but... <input type="radio">no <br><br> <input type="radio" name="" id=""> yes <input type="radio">yes, but... <input type="radio">no <br><br>
If no, which proprietary softare are present? <br> If no, which proprietary softare are present? <br>
<input type="text"> <br> <br> <input type="text"> <br> <br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br>
<h5>Governance</h5> <div class="governance">
<h5>Governance</h5>
Formal number of people inside the organization<input type="text" name="" id=""> <br>
Actual number of people involved in activities of governance and maintenance of the organization<input type="text"> <br><br> Formal number of people inside the organization<input type="text" name="" id=""> <br>
Actual number of people involved in activities of governance and maintenance of the organization<input type="text"> <br><br>
<label for="org_type">What organizational model is used?</label> <br>
<input type="radio" name="org_type" id="collective"><label for="collective">collective</label> <br> <label for="org_type">What organizational model is used?</label> <br>
<input type="radio" name="org_type" id="membership"><label for="membership">member based</label> <br> <input type="radio" name="org_type" id="collective"><label for="collective">collective</label> <br>
<input type="radio" name="org_type" id="informal"><label for="informal">informal group</label> <br> <input type="radio" name="org_type" id="membership"><label for="membership">member based</label> <br>
<input type="radio" name="org_type" id="other"><label for="other">other:</label> <input type="text" name="other_orgtype" placeholder="write here"> <br> <input type="radio" name="org_type" id="informal"><label for="informal">informal group</label> <br>
<input type="radio" name="org_type" id="other"><label for="other">other:</label> <input type="text" name="other_orgtype" placeholder="write here"> <br>
<br>Are tasks clearly and fairly distributed (for example, not only based on the skills and knowledge of each individual)?<br>
<input type="radio">yes <input type="radio">yes, but...<input type="radio">no <br>Are tasks clearly and fairly distributed (for example, not only based on the skills and knowledge of each individual)?<br>
<br><br> <input type="radio">yes <input type="radio">yes, but...<input type="radio">no
Who can make decisions? <br> <br><br>
<input type="checkbox"> <label for="">everyone in the organization</label> <br> Who can make decisions? <br>
<input type="checkbox"> <label for="">some in the organization</label><br> <input type="checkbox"> <label for="">everyone in the organization</label> <br>
<input type="checkbox"> <label for="">a representative</label><br> <input type="checkbox"> <label for="">some in the organization</label><br>
<input type="checkbox"> <label for="">people outside of the organization</label> <br> <input type="checkbox"> <label for="">a representative</label><br>
<input type="checkbox"> <label for="">Others</label> <input type="text" name="" id=""> <br> <input type="checkbox"> <label for="">people outside of the organization</label> <br>
<br> <input type="checkbox"> <label for="">Others</label> <input type="text" name="" id=""> <br>
How are decision making processes moderated? <br> <br>
<textarea name="" id="" cols="30" rows="10"></textarea> How are decision making processes moderated? <br>
<textarea name="" id="" cols="60" rows="6"></textarea>
<br> <br>
<br> <br>
Is the organization taking all the necessary caring procedures for eventual turnover (for example with exhaustive documentation)? How? <br>
<textarea name="" id="" cols="40" rows="14"></textarea> <br> Is the organization taking all the necessary caring procedures for eventual turnover (for example with exhaustive documentation)? How? <br>
<br> <textarea name="" id="" cols="60" rows="6"></textarea> <br>
<br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br> </div>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br>
<h5>Administration</h5>
<h5>Administration</h5>
<br>
What are the sources of income? (select multiple)<br> <br>
<input type="checkbox"> <label for="">Contributions from private individuals incl. companies, or associations of friends </label> <br> What are the sources of income? (select multiple)<br>
<input type="checkbox"> <label for="">Contributions from private funds </label> <br> <input type="checkbox"> <label for="">Contributions from private individuals incl. companies, or associations of friends </label> <br>
<input type="checkbox"> <label for="">Contributions from charity lotteries </label> <br> <input type="checkbox"> <label for="">Contributions from private funds </label> <br>
<input type="checkbox"> <label for="">Other contributions from private resources </label> <input type="text"><br> <input type="checkbox"> <label for="">Contributions from charity lotteries </label> <br>
<input type="checkbox"> <label for="">Other contributions from private resources </label> <input type="text"><br>
<input type="checkbox"> <label for="">Contributions from public funds </label> <br>
<input type="checkbox"> <label for="">Subsidy government (culture funds) </label> <br> <input type="checkbox"> <label for="">Contributions from public funds </label> <br>
<input type="checkbox"> <label for="">Municipality subsidy</label> <br> <input type="checkbox"> <label for="">Subsidy government (culture funds) </label> <br>
<input type="checkbox"> <label for="">European Union subsidy </label> <br> <input type="checkbox"> <label for="">Municipality subsidy</label> <br>
<input type="checkbox"> <label for="">Other subsidies from public organizations </label> <input type="text"> <br> <input type="checkbox"> <label for="">European Union subsidy </label> <br>
<input type="checkbox"> <label for="">Beers </label> <br> <input type="checkbox"> <label for="">Other subsidies from public organizations </label> <input type="text"> <br>
<input type="checkbox"> <label for="">Meals </label> <br> <input type="checkbox"> <label for="">Beers </label> <br>
<input type="checkbox"> <label for="">"In kind" facilities</label> <br> <input type="checkbox"> <label for="">Meals </label> <br>
<input type="checkbox"> <label for="">"In kind" material</label> <br> <input type="checkbox"> <label for="">"In kind" facilities</label> <br>
<input type="checkbox"> <label for="">Coverage of travel costs</label> <br> <input type="checkbox"> <label for="">"In kind" material</label> <br>
<input type="checkbox"> <label for="">Coverage of accomodation costs</label> <br> <input type="checkbox"> <label for="">Coverage of travel costs</label> <br>
<input type="checkbox"> <label for="">Other </label> <input type="text" name="" id=""> <br> <input type="checkbox"> <label for="">Coverage of accomodation costs</label> <br>
<br> <input type="checkbox"> <label for="">Other </label> <input type="text" name="" id=""> <br>
Average number of other jobs that the organization's members have: <br> <br>
<input type="text"> Average number of other jobs that the organization's members have: <br>
<input type="text">
<br><br>
<br><br>
Dependency of the members on the organization's income stream. Score from 1 (not at all) to 10 (a lot.) <br>
Dependency of the members on the organization's income stream. Score from 1 (not at all) to 10 (a lot.) <br>
<input type="text" min="1" max="10"> <br>
<br> <input type="text" min="1" max="10"> <br>
Is the current funding model/schema sustainable and wage fairly distributed? (Please elaborate)<br> <br>
<textarea name="" id="" cols="70" rows="7"></textarea> Is the current funding model/schema sustainable and wage fairly distributed? (Please elaborate)<br>
<br><br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br>
<h5>working conditions</h5>
Do people work: <br>
<input type="radio" name="" id=""><label for="">on a contract basis </label> <br>
<input type="radio" name="" id=""><label for="">on a freelance basis </label> <br>
<input type="radio" name="" id=""><label for="">on a voluntary basis </label> <br>
<input type="radio" name="" id=""><label for="">other </label> <input type="text"><br>
<br>
<br><br><br>
score the following from 1 to 10 ( 1 = not at all, 10 = a lot.) <br> <br><br>
Space and resources for failure <br>
<input type="text"> <br>
Autonomy from bigger cultural institutions and their agenda <br>
<input type="text"> <br>
Space and resource for learning administration work <br>
<input type="text"> <br>
Space and resources for learning technical things <br>
<input type="text"> <br>
Space and resources for research and experimentation <br>
<input type="text"><br>
Frustration due to technical issues <br>
<input type="text"> <br>
Time dedicated to connect with the components(members) of the organization <br>
<input type="text"><br>
Time dedicated to repair broken things?<br>
<input type="text"> <br> <br>
Time dedicated to the organization outside of designated moments<br>
<input type="text"> <br><br>
<br>
Mental load*: check as many as you feel metally loaded.<br>
* It indicates the feeling of saturation and overload due to extra time dedicated to think and worry about the organization outside of designated working hours. <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br><br><br>
Anxiety experienced<br>
<input type="color" style="width:200px;"> <br> <br>
How many nervous breakdown in the past year?<br>
<input type="text"> <br> <br>
Frustration due to inter-personal misunderstandings <br>
<input type="radio"><input type="radio"><input type="radio"><input type="radio"><input type="radio"> <input type="radio"><input type="radio"><input type="radio"><input type="radio"><input type="radio"><br><br>
Is time dedicated to address unsolved conflicts among the members of the organization?<br>
<input type="radio">yes <input type="radio">yes, but... <input type="radio">no <br><br>
Are there space and resources for emotional support? <br>
score from 1 to 10 (1 = there's none, 10 = there's a loooot)<br>
<input type="text"> <br> <br>
<br> <br>
other <input type=""> <br>
<input type="text"> <br>
<br><br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
<br>
<h5>TBC Q&A </h5>
Space for more questions: <br>
<textarea name="" id="" cols="70" rows="7"></textarea> <textarea name="" id="" cols="70" rows="7"></textarea>
<br><br>
<br><br><br> <br><br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~<br>
<h5>working conditions</h5>
Do people work: <br>
<input type="radio" name="" id=""><label for="">on a contract basis </label> <br>
<input type="radio" name="" id=""><label for="">on a freelance basis </label> <br>
<input type="radio" name="" id=""><label for="">on a voluntary basis </label> <br>
<input type="radio" name="" id=""><label for="">other </label> <input type="text"><br>
<br>
<br>
The following questions are intended to be answered individually. Score the following from 1 to 10 ( 1 = not at all, 10 = a lot). <br>
Space and resources for failure <br>
<input type="text"> <br>
Autonomy from bigger cultural institutions and their agenda <br>
<input type="text"> <br>
Space and resource for learning administration work <br>
<input type="text"> <br>
Space and resources for learning technical things <br>
<input type="text"> <br>
Space and resources for research and experimentation <br>
<input type="text"><br>
Frustration due to technical issues <br>
<input type="text"> <br>
Time dedicated to connect with the components(members) of the organization <br>
<input type="text"><br>
Time dedicated to repair broken things?<br>
<input type="text"> <br> <br>
<h5>well-being</h5>
The following questions are intended to be answered individually. Score the following from 1 to 10 ( 1 = not at all, 10 = a lot). <br><br>
Time dedicated to the organization outside of designated moments<br>
<input type="text"> <br><br>
<br>
Mental load*: check as many as you feel metally loaded.<br>
* It indicates the feeling of saturation and overload due to extra time dedicated to think and worry about the organization outside of designated working hours. <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br>
<input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"><input type="checkbox"> <br><br><br>
Anxiety experienced<br>
<input type="color" style="width:200px;"> <br> <br>
How many nervous breakdown in the past year?<br>
<input type="text"> <br> <br>
Frustration due to inter-personal misunderstandings <br>
<input type="radio"><input type="radio"><input type="radio"><input type="radio"><input type="radio"> <input type="radio"><input type="radio"><input type="radio"><input type="radio"><input type="radio"><br><br>
Is time dedicated to address unsolved conflicts among the members of the organization?<br>
<input type="radio">yes <input type="radio">yes, but... <input type="radio">no <br><br>
Are there space and resources for emotional support? <br>
score from 1 to 10 (1 = there's none, 10 = there's a loooot)<br>
<input type="text"> <br> <br>
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
<br>
<h5>TBC Q&A </h5>
Space for more questions: <br>
<textarea name="" id="" cols="70" rows="7"></textarea>
<br><br>
<br><br><br>
<input type="submit" value="submit" id="submit">
<input type="submit" value="submit" id="submit" style="width: 100%; height: 200px;">
</div>
</form> </form>

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