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Wisconsin Native Loan Fund Training Events
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1.
What is the title and date of the workshop you are attending?
(Required.)
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2.
What is your first and last name?
(Required.)
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3.
What is your mailing address?
(Required.)
4.
What is your physical address? (If different from mailing)
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5.
What is your email address?
(Required.)
6.
What is your phone number?
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7.
What county do you live in?
(Required.)
8.
What is your race?
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or other Pacific Islander
White
American Indian or Alaska Native and Black or African American
Other multiple race
Unknown
Choose not to respond
9.
What is your ethnicity?
Unkown
Hispanic
Not Hispanic
Choose not to respond
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10.
What is your gender?
(Required.)
Female
Male
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11.
Which describes where you live?
(Required.)
Urban
Suburban
Rural
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12.
What is your English proficiency status?
(Required.)
Household is limited English proficient
Household is not limited English proficient
Choose not to respond
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13.
Number of adults (18+) in family?
(Required.)
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14.
Total number of dependents in family (under
18)
(Required.)
15.
What is your gross annual income?
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16.
Do you have a disability?
(Required.)
Yes
No
17.
What is your marital status?
Single
In a relationship
Engaged
Married
Separated
Widowed
Divorced
Civil Union
Domestic Partnership
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18.
Are you a veteran?
(Required.)
Yes
No
19.
What is your education level?
Some high school or less
High school diploma
GED
Some college (no degree)
Associated degree or similar (vocational or technical degree)
Bachelor's degree
Advanced degree (master's, doctorate, etc.)
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20.
Employment status (Check all that apply)
(Required.)
Regular employment
Self employment
Unemployed
