When is your birthdate?

How do you describe your gender?

-- select an option -- MaleFemaleTransgenderTwo-SpiritNon-BinaryOtherPrefer not to answer

How do you describe your sexual orientation? Select all that apply.

-- select an option -- Gay or LesbianStraight, that is not gay or lesbianBisexualNot listed here (optional/open-ended answer)Prefer not to answer

Race

-- select an option -- American Indian or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or other Pacific Islander WhiteMultipleOtherPrefer not to answer

Are you Hispanic or Latine?

-- select an option -- YesNoPrefer not to answer