Nurture KC- Group Education Registration
The following demographic questions are required by the Healthy Start grant. No information that can identify you will be shared. You can decline to answer any of the questions below.
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1.
Are you currently...?
(Required.)
Preconceptive (no prior pregnancies, no prior children, not pregnant)
Pregnant or expecting
Postpartum (delivered less than 6 months prior to today)
Parenting an infant less than 6 months of age
Parenting a child 12- 18 months of age
None of the above
Declined to answer
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2.
What is your age in years?
(Required.)
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3.
How do you currently describe yourself?
(Required.)
Female
Male
Transgender Woman/Transgender Female/Transfeminine
Transgender Man/Transgender Male/Transmasculine
Declined to answer
I use a different term (please specify)
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4.
What sex were you assigned at birth, on your original birth certificate?
(Required.)
Female
Male
Declined to answer
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5.
Are you of Hispanic, Latino/a, or Spanish origin?
(Required.)
No, not of Hispanic, Latino/a, or Spanish origin
Yes, Mexican, Mexican American, Chicano/a
Yes, Puerto Rican
Yes, Cuban
Yes, Another Hispanic, Latino/a, or Spanish origin
Declined to answer
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6.
What is your race?
(Required.)
White
Black or African American
American Indian or Alaska Native
Asian Indian
Filipino
Japanese
Korean
Vietnamese
Other Asian
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Declined to answer
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7.
Do you speak a language other than English at home?
(Required.)
No
Declined to answer
Yes (please specify language)
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8.
How well do you speak English?
(Required.)
Very well
Well
Not well
Not at all
Declined to answer
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9.
What is the highest grade or level of school that you have completed?
(Required.)
No formal schooling
8th grade or less
Some high school (Grades 9, 10, 11 & 12)
High school diploma (completed 12th grade)
G.E.D.
Some college or 2-year degree
Technical or trade school
Graduate or professional school
Declined to answer
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10.
What group education or you registering to attend? (Live or recorded)
(Required.)
1/8/25 Family Financial Literacy
1/30/25 Nutrition for Well-Being
2/19/25 Soft Parenting During Hard Times
3/4/25 Fathers and Maternal Mental Health
4/29/25 Understanding Birth
5/9/24 Infant CPR
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11.
Are you currently enrolled as a Kansas City Healthy Start Participant at Nurture KC?
(Required.)
Yes
No
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12.
What is your email address? (This is to verify your attendance, deliver meeting links, and send any applicable gift cards.)
(Required.)
