1. Demographic Information

2. Gender:

3. Sexual Orientation:

4. Which Racial/Ethnic groups do you identify as (check all that apply)

7. How did you hear about KGA? (check all that apply)

8. Why are you interested in joining KGA's Young Women's Empowerment Program?

9. What does sisterhood mean to you? And why is it important?

10. How would you contribute to building a powerful sisterhood with other girls at KGA?

11. What is an important issue that young Khmer and/ or Southeast Asian women face in your community?

12. We want to know a little more about you. Anything else you want to share with us about yourself (ex: qualities,interests, goals, life struggles, etc)?