Social Identity Questions

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Your answers to the questions below will be anonymous. The goal of these questions is to understand the communities we serve and how we can better serve them.

Which describes you? Check all that apply *

Native American, American Indian, or Alaska Native

Asian or Asian American

Black or African American

Hispanic, or Latina, Latino, Latinx, or Spanish Origin

Native Hawaiian or other Pacific Islander

Middle Eastern

White

Prefer not to say

None of the above

Required

If you did not see yourself in the list provided above, please self-describe:

What is your age? *

Under 18

18-24 years

25-44 years

45-64 years

65 years and over

Prefer not to say

In Chapel Hill the average household income is $73,614 per year. Is your household over/under the average? *

Over

Under

Prefer not to say

What is your gender? *

Female

Male

Non-binary / genderqueer / third gender

Prefer not to say

None of the above

If you did not see yourself in the list provided above, please self-describe:

Would you describe yourself as transgender? *

Yes

Prefer not to say

Do you consider yourself a member of the lesbian, gay, bisexual, transgender, questioning, queer (LGBTQQ) community? *

Yes

No, but I identify as an Ally

Prefer not to say

Do you identify as having a disability as defined under the Americans with Disabilities Act (ADA)? Check all that apply *

D/deaf / hearing impaired

Mentally ill / psychiatric disability

Neurodivergent (Autism, ADD / ADHD, auditory / sensory processing differences)

Physical impairment

Low vision / visually impaired / blind

Chronic illness

Cognitive disabilities

None of the above

Prefer not to say

Other:

Required

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