Voluntary Identification
1.
Gender Identification
Male
Female
Non-Binary
Choose Not to Identify
2.
What is your ethnic background?
White
Black or African American
Hispanic or Latino
Asian or Asian American
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Other/Two or More Races
Choose Not to Identify
3.
Are you a Veteran of the U.S. Armed Forces or a surviving spouse?
Yes, I am a Veteran or surviving spouse
No, I am not a Veteran or surviving spouse
Choose not to disclose
4.
What state do you reside in?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia (DC)
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
5.
How did you hear about this call for entry?
Online
Friend
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Other (please specify)