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Section 1 of 3
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1.
99-01
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99-02
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00-01
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00-02
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01-01
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01-02
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02-01
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03-01
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07-01
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19-01
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Section 2 of 3
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Question
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1.
Female
2.
Male
3.
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1.
16 to 20
2.
21 to 25
3.
26 to 30
4.
31 to 35
5.
36 to 40
6.
41 to 45
7.
over 45
8.
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Puerto Rico
United States
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1.
Adjuntas
2.
Aguada
3.
Aguadilla
4.
Aguas Buenas
5.
Aibonito
6.
Arecibo
7.
Arroyo
8.
Añasco
9.
Barceloneta
10.
Barranquitas
11.
Bayamón
12.
Cabo Rojo
13.
Caguas
14.
Camuy
15.
Canóvanas
16.
Carolina
17.
Cataño
18.
Cayey
19.
Ceiba
20.
Ciales
21.
Cidra
22.
Coamo
23.
Comerío
24.
Corozal
25.
Culebra
26.
Dorado
27.
Fajardo
28.
Florida
29.
Guayama
30.
Guayanilla
31.
Guaynabo
32.
Gurabo
33.
Guánica
34.
Hatillo
35.
Hormigueros
36.
Humacao
37.
Isabela
38.
Jayuya
39.
Juana Díaz
40.
Juncos
41.
Lajas
42.
Lares
43.
Las Marías
44.
Las Piedras
45.
Loiza
46.
Luquillo
47.
Manatí
48.
Maricao
49.
Maunabo
50.
Mayagüez
51.
Moca
52.
Morovis
53.
Naguabo
54.
Naranjito
55.
Orocovis
56.
Patillas
57.
Peñuelas
58.
Ponce
59.
Quebradillas
60.
Rincón
61.
Rio Grande
62.
Sabana Grande
63.
Salinas
64.
San Germán
65.
San Juan
66.
San Lorenzo
67.
San Sebastián
68.
Santa Isabel
69.
Toa Alta
70.
Toa Baja
71.
Trujillo Alto
72.
Utuado
73.
9
74.
Vega Baja
75.
Vieques
76.
Villalba
77.
Yabucoa
78.
Yauco
79.
N/A
80.
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1.
N/A
2.
Alabama - AL
3.
Alaska - AK
4.
Arizona - AZ
5.
Arkansas - AR
6.
California - CA
7.
Colorado - CO
8.
Connecticut - CT
9.
Delaware - DE
10.
Florida - FL
11.
Georgia - GA
12.
Hawaii - HI
13.
Idaho - ID
14.
Illinois - IL
15.
Indiana - IN
16.
Iowa - IA
17.
Kansas - KS
18.
Kentucky - KY
19.
Louisiana - LA
20.
Maine - ME
21.
Maryland - MD
22.
Massachusetts - MA
23.
Michigan - MI
24.
Minnesota - MN
25.
Mississippi - MS
26.
Missouri - MO
27.
Montana - MT
28.
Nebraska - NE
29.
Nevada - NV
30.
New Hampshire - NH
31.
New Jersey - NJ
32.
New Mexico - NM
33.
New York - NY
34.
North Carolina - NC
35.
North Dakota - ND
36.
Ohio - OH
37.
Oklahoma - OK
38.
Oregon - OR
39.
Pennsylvania - PA
40.
Rhode Island - RI
41.
South Carolina - SC
42.
South Dakota - SD
43.
Tennessee - TN
44.
Texas - TX
45.
Utah - UT
46.
Vermont - VT
47.
Virginia - VA
48.
Washington - WA
49.
West Virginia - WV
50.
Wisconsin - WI
51.
Wyoming - WY
52.
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Yes
No
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Section 3 of 3
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Yes
No
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PR Youth Challenge Academy
YCC
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Question
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Study
Working
Community Service or Volunteer
Military
Unemployed
Other…
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Question
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1.
Certificate
2.
Technical course
3.
Associate degree
4.
Bachelor degree
5.
Master's degree
6.
Doctorate
7.
Only the high school diploma
8.
Lower than the high school diploma
9.
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Engineering Program
Arts
Automotive technician
Education
Health Science
N/A
Other…
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1.
N/A
2.
Army
3.
Marine Corps
4.
Navy
5.
Air Force
6.
Coast Guard
7.
Army National Guard
8.
Army Reserve
9.
Marine Corps Reserve
10.
Navy Reserve
11.
Air National Guard
12.
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Título sin título
SELECT YOUR CLASS
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General information
Name
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Gender
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Age Range?
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Where you live now?
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Select the town where you live in Puerto Rico: Choose N/A if not applicable.
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Select the state where you live: Choose N/A if not applicable.
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Town where you live outside the US or PR: Write N/A if not applicable.
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Do you still have contact with your mentor?
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Placement Information
Did you graduate from the Academy?
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What program do you belong to?
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What are you doing now?
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Which is the highest level of study that you get?
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What study title did you get?
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Select your Military Branch:
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Mention your last 3 jobs title?
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