internal use only -- do not make this form liveused to generate and manage customized Predefined Context, like commonly used questions

internal use only -- do not make this form live
used to generate and manage customized Predefined Context, like commonly used questions

Predefined Content Item #1 -- Demographics

GROUP

The information below is not required and you may select “Prefer not to answer”. Eligibility for TALA programs is not affected by your answers to these questions. The answers to the following five questions will only be used in the aggregate for reporting purposes.

What is your race/ethnicity?

Are you of Hispanic/Latino/Spanish heritage?

Your race/ethnicity, if not listed above:

What is your gender?

Do you self-identify as a member of the LGBTQIA community?

Are you a veteran?

Contact Information