English Español English Survey 1: Demographic for Online Video Series 2019-2020 Your answers to the following questions are confidential and will help us understand the diversity of who we are serving. You are not required to answer any questions. OK Question Title * 1. What Month and Year did you view the Online Parent Education Series? OK Question Title * 2. What Video did you watch? OK Question Title * 3. Please mark the appropriate choice: Parent Professional Professional & Parent Other (please specify) OK Question Title * 4. What is your zip code? OK Question Title * 5. What is your age group? 0-15 16-25 26-59 60+ Decline to State OK Question Title * 6. Gender assigned at birth Male Female Decline to State OK Question Title * 7. Current Gender Identitiy Male Female Transgender Genderqueer Questioning or Unsure Another Gender Identity Decline to State OK Question Title * 8. What is your race? American Indian or Alaskan Native Asian Black or African American Native Hawaiian or other Pacific Islander White/Caucasian Other More than one race Decline to State OK Question Title * 9. What is your ethnicity? Caribbean Central American Mexican/Mexican-American/Chicano Puerto Rican South American African Asian Indian/South Asian Cambodian Chinese Eastern European European Filipino Japanese Korean Middle Eastern Vietnamese Other Multi-Racial Decline to State OK Question Title * 10. Sexual Orientation Gay or Lesbian Heterosexual or Straight Bisexual Questioning or Unsure Queer Another Sexual Orientation Decline to Anser OK Question Title * 11. What is your home language? English Spanish Other (please specify) OK Question Title * 12. How many children do you have? OK Question Title * 13. What are the ages of your children? OK Question Title * 14. Select all that apply: Vision Impaired Hearing Impaired Physical Mobility Chronic Health Condition Other Disasbility Open CWS Case or Required to take a class Veteran Homeless Other (please specify) OK Question Title * 15. How much schooling have you had? No high school High School Diploma Bachelor's Degree Some high school Associate degree Graduate Degree OK Question Title * 16. What is your yearly income? 0-20,999 21,000-35,999 36,000-49,999 50,000-74,999 75,000-99,999 100,000 or more OK Question Title * 17. If you would like to stay connected with Parent Connection of San Luis Obispo County please leave your name & email below: OK Question Title * 18. Would you like a Parent Coach to contact you? Leave your name and number for someone to follow up with you: OK Question Title * 19. Do you have any questions or comments for us? OK DONE