✊ Jai Bhim ✊

Dalit Empowerment Community Survey

📢 Your voice matters! Together we build Dr. B.R. Ambedkar's vision of equality, justice, and fraternity. ★ ✊ Educate, Agitate, Organize — Dr. B.R. Ambedkar ★ 📢 Your voice matters! Together we build Dr. B.R. Ambedkar's vision of equality, justice, and fraternity. ★ ✊ Educate, Agitate, Organize — Dr. B.R. Ambedkar ★

🌐 Language: English ಕನ್ನಡ हिंदी

✊ Jai Bhim Community Survey 2026

Bhimrao Ambedkar
Community Survey

Building Dr. B.R. Ambedkar's vision of Equality, Justice & Fraternity

Responses

Questions

~10

Minutes

✊

Welcome to Jai Bhim Community Survey

Your voice matters! This survey helps us understand our community better and work towards its empowerment following Dr. B.R. Ambedkar's vision of equality and social justice. It takes approximately 10 minutes to complete.

⚡

Quick & Easy

🔒

Secure & Private

✊

For Our Community

💡 A unique taluk code is required to start the survey. Please contact your community coordinator.

🔒 Your information is confidential and will not be shared or used for marketing purposes.

📋 Personal Information

1. Name *

2. Gender *

Male Female Others

3. Father's Name *

4. Mother's Name *

5. Village *

6. District *

7. Taluk *

8. Education *

9. Occupation *

10. Marital Status *

10.1 Spouse / Husband Name *

11. Phone Number * 📱 Enter 10-digit Indian mobile number (e.g., 9876543210)

12. Email (Optional)

13. Religion *

14. Caste *

SC (Scheduled Caste) ST (Scheduled Tribe) OBC General

15. Sub Caste *

✊ Community Voice & Vision

16. What does Social Equality mean to you? *
(You can select one or more options)

Equal respect and dignity for all people Equal access to education, jobs, and government benefits Freedom from discrimination based on caste or tribe Equal voice and participation in society and community decisions

17. What does "Ambedkar / Ambedkarism" signify for you? *
(You can select one or more options)

A vision for social reform and transformation of society Awareness about constitutional values and democratic rights Strength to question injustice and unfair traditions A guiding philosophy for unity, justice, and fraternity

🤝 Community Engagement

18. Are you associated with any Dalit / backward class organizations / NGOs / Trusts? *

Yes No

18.1 If Yes, please specify your association:

Self-Help Groups (SHGs) Dalit Rights Group Other Organization

19. Are you associated with any Political Party? *

Yes No

19.1 Which Political Party? *

20. Have you ever contested for any elections? *

Yes No

20.1 If Yes, which election level?
(Select all that apply)

GP – Gram Panchayat TP – Taluk Panchayat ZP – Zilla Panchayat MLA – Member of Legislative Assembly MLC – Member of Legislative Council MP – Member of Parliament

21. Are You Willing to Volunteer for Dalit empowerment programs? *

Yes No

22. Are You Willing to fight for Equality? *

Yes No

23. Jai Bheem — Your Pledge *
Sign your name below as a pledge to Dr. B.R. Ambedkar's ideals of equality, justice, and fraternity.

✊ Jai Bhim ✊

Welcome to Jai Bhim Community Survey

📋 Personal Information

✊ Community Voice & Vision

🤝 Community Engagement

Jai Bhim! Thank You!