Demographic Form

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Demographic Form

Hello! Thanks for taking our survey. This information is collected for demographic tracking purposes and helps our non-profit ensure we are reaching diverse communities.

Which workshop or program are you enrolled in? *

Have you participated in a Cyber Creationz Tech program before? *

Yes

I don't know

What are your pronouns *

She / Her

He / Him

They / Them

Prefer not to answer

Other:

What is your age? *

Under 12

12 - 14

15 -17

18 - 24

25 +

Perfer Not to Answer

What is your ZIP code *

How do you describe your race and/or ethnicity *

American Indian or Alaska Native

Asian / Asian American

Black or African American

Hispanic, Latino, or Spanish origin

Native Hawaiian or Other Pacific Islander

White

Prefer not to answer

Other:

Required

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