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C4 Demographic Survey

This survey is for members of the Community Caring Collaborative Council. The purpose of this survey is to gather data for one of our major funders on the demographic makeup of our board. This survey is completely optional and responses will remain anonymous.

1. Race & Ethnicity(Required)
Please check which of the following you self-identify as:
2.a Gender Identity(Required)
Please check which of the following you self-identify as:
2.b Gender Identity(Required)
Please check which of the following you self-identify as:
3. Sexual Orientation(Required)
Please check which of the following you self-identify as:
4. Disability Status(Required)
Please check which of the following you self-identify as: