College STEM Program Participant Demographics Form
Full Name
Date of Birth
Gender
Male
Female
Non-binary
Prefer not to say
Other
Race/Ethnicity
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Two or more races
Other
Prefer not to say
Academic Year
Freshman
Sophomore
Junior
Senior
Graduate
STEM Major
First-generation College Student?
Yes
No
Prefer not to say
Do you identify as a person with a disability?
Yes
No
Prefer not to say
Citizenship Status
U.S. Citizen
Permanent Resident
International Student
Other
Prefer not to say
Additional Comments