The Wardrobe Demographic Survey (Staff/Board)
First Name
Last Name
Preferred Name
Informal or Nickname
Phone
Type of Phone Number
Please select...
Mobile
Work
Home
Email
Primary email you will use to interact with The Wardrobe.
Type of Email
Please select...
Personal
Work
Alternate
Demographics
What is your gender?
Please select...
Female
Male
Non-Binary/Third Gender
Prefer not to say
Preferred Pronouns
When is your birthday? (We like to celebrate!)
What is your race?
Please select...
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Multiracial
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
What is the highest level of education you have completed?
Please select...
Some high school, no diploma
High school diploma or GED
Some college, no degree
Associates Degree
Bachelors Degree
Post-Graduate Degree (Masters/JD/PhD/MD)
Prefer not to answer
The Wardrobe is committed to including people whose backgrounds reflect those of the communities we serve. Providing answers to these following questions will only be used to evaluate our efforts.
Have you or your family ever used any of the following public benefits?
Select all that apply.
Cash assistance/TANF
Child Care Assistance (CCIS)
Disability/SSI
Food Stamps/SNAP
Health Benefits (CHIP, Medicaid, Pace, or Medicare)
Housing Assistance
Unemployment Compensation
Do any of the following apply to you or your immediate family?
Select all that apply.
Experience with the criminal justice system (probation, parole, detention)
Newcomer to the US (i.e., refugee, migrant, immigrant)
LGBQIA+
Transgender, intersex or nonbinary
Disability (mental or physical)
Veteran Status
Contact Information