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Hellenic Foundation Community Awareness
1. Demographics:
*
1
. Gender?
Male
Female
Gender?
*
2
. Age?
0-18
19-29
30-39
40-49
50-59
60-69
70-79
80-89
90-99
100+
Age?
*
3
. Ethnic Background/Country of Origin:
Ethnic Background/Country of Origin:
African
Asian
Australian
European
North American
South American
Please Specify Country
*
4
. Marital Status
Marital Status
Single, Never Married
Married
Divorced
Widowed
5
. Children under age 25 living in household?
Children under age 25 living in household?
Yes
No
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