Age: ___________
What is your gender? ___________
(select all that apply)
[ ] My gender is the same what was written on my original birth certificate
[ ] My gender is different than what was written on my original birth certificate
[ ] I consider myself cisgender
[ ] I consider myself transgender
[ ] I don't consider myself cisgender or transgender
[ ] Prefer not to answer
How do you describe your sexuality? (select all that apply)
[ ] Asexual
[ ] Bisexual/Pansexual
[ ] Gay/Lesbian
[ ] Heterosexual/Straight
[ ] Queer
[ ] Questioning
[ ] Prefer not to answer
[ ] I use a different term: ___________
How do you describe your race/ethnicity?: (select all that apply)
[ ] American Indian or Alaska Native
[ ] Asian
[ ] Black, African American, or African
[ ] Hispanic, Latino, or Spanish
[ ] Middle Eastern or North African
[ ] Native Hawaiian or Pacific Islander
[ ] White
[ ] Prefer not to answer
[ ] I use a different term: ___________
What is your highest education level?
- Less than high school
- High school graduate
- Some college
- 2-year degree
- 4-year degree
- Professional degree
- Doctorate
- Prefer not to answer
Please rate your overall ability in the English language:
- Native (learned from birth)
- Fully competent in speaking, listening, reading, and writing, but not native
- Limited but adequate competence in speaking, reading, and writing
- Restricted ability (e.g., only reading or speaking/listening)
- Some familiarity (e.g., a year of instruction in school)
- Prefer not to answer