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  1. Surveys
  2. 2017
  3. March
  4. D
  5. Demographic Questionnaire for Study
0%
Questions marked with a * are required Exit Survey
 
 
* When were you born?
   
 
 
 
Gender
 
Male
 
Female
 
 
 
Your ethnic and racial background
 
African-American, Black
 
Chinese
 
Filipino
 
Korean
 
Hispanic or Latimo
 
Mexican
 
More than one race
 
Unknown or not reported
 
Decline to Answer

 
 
 
* Where were you born (city/region, country)
   
 
 
 
Are you a United States citizen?
 
Yes
 
No
 
Decline to answer

 
 
 
Are you a native English speaker
 
Yes
 
No
 
Decline to answer
 
 
 
If NO, how long have you been speaking English? (years)
 
1-3
 
4-6
 
7-9
 
10-12
 
13+
 
 
 
In terms of education and income, would you describe your parents as:
 
Upper class
 
Upper-Middle class
 
Middle class
 
Lower-middle class
 
Working class
 
Decline to answer
 
 
 
Which grade/class level best decribes you?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
 
 
Do you have siblings? If YES, how many?
 
0
 
1-3
 
4-6
 
7-9
 
9+