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Choosing to complete this survey is voluntary and completely anonymous.

 
Thank you for your willingness to participate in the Maryland Motor Vehicle Administration's Parent Participation Survey in Driver Education. Results from this survey will be used to make changes to the Driver Education Curriculum. We welcome your feedback and thank you in advance.

IF YOU WOULD LIKE TO FIND OUT MORE INFORMATION OR GET QUESTIONS ANSWERED IN REGARDS TO THIS SURVEY, CONTACT:

Dr. Patricia Dischinger
National Study Center for Trauma and EMS
University of MD Baltimore,
110 S. Paca St., 4th Floor
Baltimore, MD 21201
PHONE: 410-328-7491
HP-00042846

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* 1. What is your gender?

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* 2. What is your age?

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* 3. Indicate the COUNTY where you LIVE:

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* 4. What is your home Zip Code?

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* 5. Do you consider yourself to be Hispanic? (Includes: Puerto Rican, Cuban/Cuban American, Dominican (Republic), Mexican, Mexican American, Central or South American, Other Latin American, Other Hispanic/Latino)

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* 6. What race do you consider yourself to be? (check all that apply)

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