Convenience Survey - Needs Assessment 2011 Question Title * 1. What is your gender? Male Female Question Title * 2. What is your age? Under 12 12-15 16-18 19-21 22-30 31-40 41-50 51-60 60+ Question Title * 3. What is your race? Select only one that best describes your race. White Black or African American American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander More than One Race Other Next