Participant #________________
Demographic Information
1. In what month and year were you born? _________________ __________________
month year
2. What is the highest grade or year of school you have completed?
Less
than high school
Completed
high school
Some
college, no degree (indicate area of study:
____________________________________)
Associate’s
degree (AA/AS) (indicate area of study:
__________________________________)
Bachelor’s
Degree (BA/BS) (indicate area of study:
__________________________________)
Post-Bach
degree (indicate degree and area of study:
________________________________)
3. Are you male or female?
Male
Female
4. Are you of Hispanic, Latino, or Spanish origin?
Yes
No
5. What is your race? Choose one or more races.
White
Black
or African American
American
Indian or Alaska Native
Asian
Native
Hawaiian or Other Pacific Islander
6. What is the primary language spoken in your home?
English
Spanish
Some
other language - Please specify _____________________________
7. In what country were you born? _________________________
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | roman314 |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |