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Age
   
 
 
 
Gender
 
Male
 
Female

 
 
 
Marital Status
 
Single
 
In a relationship
 
Married
 
Divorced
 
Widowed

 
 
 
Race
 
Caucasian
 
African-American
 
Hispanic
 
Native-American
 
Asain-American
 
Other _______________

 
 
 
What type of community did you grow up in or spend most of your youth?



 
Large Metropolitan
 
Mid-size Metropolitan(50K-100K)
 
Small Metropolitan(20K-49K)
 
Small Town(under 19K)
 
Rural

 
 
 
Where do/did you attend college?
   
 
 
 
What is you class rank?
 
Freshman
 
Sophomore
 
Junior
 
Senior
 
Graduate Student

 
 
 
What is your major and minor?
   
 
 
 
Residence
 
On campus
 
Off campus

 
 
 
Are you or have you ever been a student athlete? If so what sport(s) did you play?
 
Yes ______________________
 
No

 
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