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2013 Teen Dating Violence Summit Audience Survey
Demographic Information
*
1.
What is your age?
(Required.)
*
2.
What is your gender?
(Required.)
Female
Male
Transgender
*
3.
What is your race?
(Required.)
Caucasian (White)
Black or African American
Asian or Pacific Islander
American Indian or Native American
Other (please specify)
*
4.
Are you Hispanic?
(Required.)
Yes
No
5.
What is your home zip code?
