Space Foundation Student Intake Survey

Welcome to the Space Foundation! We are so excited to have you participate in our programs. Please answer the following questions to help us get to know you better and provide you with the support you need in this program. This survey will take about 15 minutes to complete. Thank you!

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* 1. What's the name of the Space Foundation program you're participating in?

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* 2. What school do you go to?

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* 3. Where is your school located?

City/Town

State

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* 4. What grade are you in?

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* 5. What is your gender? (choose all that apply)

Female

Male

I prefer not to say

Another. Let me describe:

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* 6. What is your racial/ethnic background? (choose all that apply)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Multiracial

Native Hawaiian or other Pacific Islander

White

I prefer not to say

Let me describe:

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* 7. Are any of your parents or guardians active-duty or retired military?

Yes

I don't know