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Youth Town Hall 2022 Survey
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email
(Required.)
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4.
Phone Number
(Required.)
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5.
Role
(Required.)
Performer
Youth Audience Attendee
Dg Staff and/or Event Staff (organization, wellness etc)
Parent
Teacher
Other (please specify)
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6.
Your Age
(Required.)
under 13
13-17
18-24
25-34
35-44
45+
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7.
What grade are you in?
(Required.)
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8.
What school are you attending this school year?
(Required.)
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9.
Were you born and raised in New Orleans?
(Required.)
Yes
No
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10.
Race/Ethnicity
(Required.)
Black/African-American
White
Latinx
Asian
Indigenous American
More Than One Race
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11.
Do you identify as having a disability?
(Required.)
Yes
No
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12.
Do you identify as LGBTQIA+?
(Required.)
Yes
No
