Participant Information

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* 1. Contact Information

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* 2. Date of birth

Date

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* 3. Are you a veteran of the U.S. Armed Forces?

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* 4. Are you a US citizen or are you authorized to work in the United States?

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* 5. What is your race?

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* 6. Are you of Hispanic, Latino, or Spanish origin?

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* 7. What is your Gender Identity?

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* 8. Are you or will  you be the first person in your family to receive a college degree (Parents, grandparents, siblings do not have a college degree)?

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* 9. Do you have lived experience with mental health disorders (self or family member)?

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* 10. Do you have lived experience with substance abuse disorders (self or family member)?

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* 11. Are you currently in recovery?

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* 12. Are you currently employed?

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* 13. What is the highest grade or level of school you have completed or highest degree you have received?

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* 14. Do you hold any Certifications or Licensures?

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* 15. Do you have a valid Drivers License?

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* 16. Please list any additional cities or towns you lived in before you turned 18? Please include the state if not in Illinois.

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20% of survey complete.

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