SBGA Summit 2010- Registration Survey

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1. Age Range

Age Range   16-20 21-30 31-40 41-50 51-60 61+

2. Sex/Gender

Sex/Gender   Male Female Transgender

Other (please specify)

3. I identify myself as:

I identify myself as:   Bisexual Gay Lesbian Queer Straight Transgender

4. Race

Race   Black/African American Biracial Multiracial White/Caucasian Latino Asian/Pacific Islander

Other (please specify)

5. Geographic location (please indicate the region you reside in)

Geographic location (please indicate the region you reside in)   Northeast South Midwest West

Other (please specify)

6. Religion

Religion   Atheist Baha'i Faith Buddhist Christian Hindu I do not practice a religion Islamic Judaism Muslim Rastafarian

Other (please specify)

7. Highest Level of Education

Highest Level of Education   <High School Diploma/GED High School Diploma/GED Associate's Degree Bachelor's Degree Master's Degree Ph.D.

Other (please specify)

8. Occupation

Occupation   Accounting/Finance Clergy Construction Criminal Justice/Law Education Engineering Fashion/Design Government Health Care Hospitality Human Resources Media/Broadcasting Music/Entertainment Non Profit Sales/Marketing Social Services

Other (please specify)

9. How did you hear about the Summit?

How did you hear about the Summit?   Email Flyer Radio Social Marketing (Facebook, Twitter) Television Website

Other (please specify)