Education Demographics Template

Question Title

* 1. Which best describes your gender?

Man

Woman

Non-binary

A gender not listed here (please specify)

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* 2. Are you transgender?

Yes

Questioning

Prefer not to say

Question Title

* 3. What is your race or ethnicity?

Asian

Black or African American

Hispanic or Latino

Middle Eastern or North African

Multiracial or Multiethnic

Native American or Alaska Native

Native Hawaiian or other Pacific Islander

White

Another race or ethnicity, please describe below

Self-describe below:

Question Title

* 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?

Question Title

* 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