College Survey Question Title * 1. Student Grade 9th 10th 11th 12th Other (please specify) Question Title * 2. Name of school district student is currently attending. Question Title * 3. Where will you be applying? College/University Trade/Technical School Both Question Title * 4. Gender Male Female Prefer not to identify Other (please specify) Question Title * 5. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305) Question Title * 6. Race/Ethnicity Hispanic/Latinx African American Asian White/Caucasian Bi/Multiracial Native American Alaskan American Other (please specify) Question Title * 7. What is your current household income range? Less than $5,000 $5,000 - $9,999 $10,000 - $14,999 $15,000 - $24,999 $25,000 - $34,999 $35,000 - $44,999 $45,000 - $49,999 $50,000 - $54,999 $55,000 - $59,999 $60,000 - $69,999 $70,000 - $79,999 $80,000 - $89,999 $90,000 - $99,999 More than $100,000 Question Title * 8. Is your household receiving any of the following benefits? (check all that apply) SNAP (Food Stamps) WIC Disability (federal SSI-D, SSI) Housing Voucher Temporary Assistance to Needy Families (TANF) Free/reduced lunch Other (please specify) Question Title * 9. How did you hear about the workshop? (Check all that apply) Email Family member A friend Flyer Library Newspaper Organization Social Media United Way of Greater Mercer County Website Other (please specify) Question Title * 10. If you would like to sign up for college-related information, please provide an email address below. Done
