We want to know what YOU think.
We want to really understand what young people want and need to be engaged, empowered, and happy in their communities. We want to know what will help you stay in or move to a rural Kansas community. By answering the following questions, you'll help us move forward by ensuring a great representative mix of Kansans. Thank you! Marci Penner of the Kansas Sampler Foundation will be doing the interviews.
Name
Address
City (where you live now) and zip code
County
Hometown
Email
Cell phone
Race (select all that apply)
Clear selection
Other, optional to specify
Hispanic or Latino:
Clear selection
Gender
Clear selection
Sexual orientation
Clear selection
Age
Education attainment
Clear selection
Job/means of income (share as much as you'd like)
Hobbies/Volunteer groups
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy