Education Demographics Template

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* 1. What is your gender identity?

Man

Woman

Non-binary

Prefer to self-describe (please specify)

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* 2. Do you identify as transgender or non-binary?

Yes

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* 3. Which race or ethnicity best describes you? (Select all that apply)

American Indian or Alaska Native

Asian or Asian-American

Black or African-American

Hispanic or Latino/a

Middle Eastern or North African

Native Hawaiian or Pacific Islander

White

Another race (please specify)

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* 4. What year were you born?

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* 5. What was the primary language spoken in your childhood home? (Please choose only one.)

Chinese

English

French

German

Italian

Korean

Russian

Spanish

Tagalog

Vietnamese

Other/multiple languages (please specify)

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* 6. Please describe what language(s) were primarily spoken in your childhood home.

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* 7. What is the highest level of education you have completed?

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* 8. What is your approximate average household income?

$0-$24,999

$25,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$124,999

$125,000-$149,999

$150,000-$174,999

$175,000-$199,999

$200,000 and up