Race,Ethnicity and or Immigration Life

Exit Survey »

Hello:

You are invited to participate in an interview on race and ethnic relations. In this survey, a variety of people will be asked to complete a survey that asks questions about life as an immigrant or as an (bi) racial/ethnic American. It should not take much time to fill out. The more surveys I have filled, the better! So please, send this to anyone who would be interested!

As you complete the survey, please be aware that I am choosing one of you to be apart of a individual analysis that details your life story and it's relation to race and ethnicity.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important that I learn your opinion and learning about the issues that are most pressing for racial/ethnic/immigrant groups.

Your survey responses will be strictly confidential and data from this research will be used only by me for this specific topic alone. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Asia Hussain at (703) 297-5105 or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

I Agree

Name:

What is your date of birth?

Gender:

Male

Female

Race:

Ethnicity:

Do you know the difference between the terms race and ethnicity?

Yes

Place of Birth:

Current Residence:

Are you a U.S. Citizen?:

Yes