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Black Women Running
Demographic Information
This section is background information for understanding who you are
1.
What is your age?
17 or younger
18-20
21-29
30-39
40-49
50-59
60 or older
2.
Which race/ethnicity best describes you? (Please choose only one.)
American Indian or Alaskan Native
Asian / Pacific Islander
Black or African American
Hispanic
Hispanic-non white
Other (please specify)
3.
Select the gender that you most identify with
Male
Female
Other
4.
Do you consider yourself to be:
Heterosexual
Homosexual
Bisexual
Transgendered
5.
What is the highest level of school you have completed or the highest degree you have received?
Less than high school degree
High school degree or equivalent (e.g., GED)
Some college but no degree
Associate degree
Bachelor degree
Graduate degree
6.
What is your marital status ?
Single
Married
Divorced
Separated
Widowed
7.
Which of the following categories best describes your employment status?
Employed, working full-time
Employed, working part-time
Not employed, looking for work
Not employed, NOT looking for work
Retired
Disabled, not able to work
8.
What city do you currently live in?
9.
In what state or U.S. territory do you live?
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia (DC)
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Virgin Islands
Washington
West Virginia
Wisconsin
Wyoming
10.
How many children, by age, currently live in your household? If none, type in 0
none
Less than 1 year old
1 year old
2 years old
3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old or older
11.
Were you born in the United States? If NOT, then what is your country of origin?
12.
Are you a member of a Sorority? If yes which one
Alpha Kappa Alpha
Delta Sigma Theta
Sigma Gamma Rho
Zeta Phi Beta
Not a member of a sorority
Other (please specify)
