EmailMe Form - Demographics Survey

1. What is your age? *

2. What is your gender identity? *

3. What is your sexual orientation? *

4. What is your nationality? *

5. What is your current level of education? *

6. What is your religious/spiritual belief? *

7. What is your current work status? *

8. What is/are your living arrangement(s)? Tick all that apply. *

9. What is your current relationship status? *

10. Do you have a(ny) child(ren)? *

Yes

No

11. Do you live with your child(ren)? *

Yes

No

Not Applicable

12. Do you have a disability? *

Yes

No

13. Who are you open to about your sexuality? Tick all that apply. *

14. What are your reasons for not being open? Tick all that apply. *

15. Where do you socialize or meet new people? Tick all that apply. *

16. How did you hear about this survey? *