Raising Consciousness: Education, Path to Empowerment
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Please answer these few questions about yourself.
*
1
. Please enter the initials of your first and last name
Please enter the initials of your first and last name
*
2
. Please enter your month and year of birth as a 4 digit number. Example: If your birthday is March 04, 1995, you would enter 0395.
Please enter your month and year of birth as a 4 digit number. Example: If your birthday is March 04, 1995, you would enter 0395.
3
. Gender
Gender
Male
Female
4
. Age
Age
5
. Grade Level
Grade Level
9th
10th
11th
12th
6
. What is the name of your school?
What is the name of your school?
Weequahic High School
University High School
Kearny High School
East Orange School District
Orange School District
7
. What is your current career interest?
What is your current career interest?
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