1. Student Information

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50% of survey complete.

Please enter your name and address

Which grade are you finishing right now?

What is your gender?

Did you qualify for free or reduced lunch last school year?

Which race/ethnicity best describes you? (Please choose only one.)

What's the best way to contact you about program updates? Please provide:

Please give the name, address, email and cell phone of your parents or guardian.

With whom do you reside?

What is the primary language you speak at home?