Participant Survey

MM slash DD slash YYYY
Were you born Male of Female?
Which gender do you identify as?
Do you consider yourself to be:
In what type of community do you live?
What is your race?
What is the highest level of school you have completed or the highest degree you have received?
Which of the following categories best describes your employment status?
How much money did YOU personally earn in the last 12 months? This includes money from jobs; net income from business, pensions; dividends; social security payments; and any other money income received by YOU. Please do not subtract the amount you paid in taxes or any deductions listed on your tax return.