1.What is your ethnic identity?

Asian (e.g. Asian Indian, Vietnamese, Chinese, Korean, Japanese etc. . .)

Black/African Ancestry (e.g. African American, Ethiopian, etc . . .)

Latino/a/x

Native American or Alaska Native

Native Hawaiian or Other Pacific Islander

White

Decline to State

Other ( & Self Identified: Multi-Racial) Please specify:

2.What is your gender identity?

Male

Female

Non-binary

Decline to State

Other (please specify)

3.What is your sexual orientation?

Heterosexual

Homosexual

Bisexual

Decline to State

Other (please specify)

4.What is your annual household income?

Less than $25,000

$25,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 - $149,999

$150,000 - $199,999

$200,000 and more

Decline to State

5.Which language(s) do you speak at home?

English

Spanish

Chinese

Tagalog

Vietnamese

Other (please specify)