The HTS Center For Justice, Love, and Belonging and the Pathways For Tomorrow Initiative Survey

PLEASE COMPLETE THE FOLLOWING SURVEY TO REGISTER.

YES

If you are a student, what is the name of your institution?_________________________________________________________

If you are not a student, please indicate your status

____ Local Community Member

____ Clergy

____ Faculty

____ Other (please specify) ________________________________

____ Black or African American

____ Caucasian

____ Hispanic / Latino

____ American Indian or Alaska Native

____ Asian

____ Native Hawaiian or Other Pacific Islander

____ Other (please specify) ______________________________

____ Choose not to answer

____ 18-40

____ 41-60

____ 61-75

____ 75 & Older

____ Choose not to answer

____ Woman

____ Man

____ Transgender

____ Non-Binary

____ Not Listed

____ Prefer not to reply