P+C Evaluation 1

Step 1 of 5

About You

The following questions will give Citizen University some basic info about you. We collect demographic data to help us understand who we are reaching in an effort to be equitable and accessible for all. We strive to bring a wide array of perspectives and experiences into our programs. Please feel welcome to write in “prefer not to say” for any question below. We want to be very transparent about how we are using the information you provide us. Citizen University will never share, trade, or sell this information to anyone, and your program feedback will be separated from your name and demographic data before review. Thanks for sharing!
say a word about how you interact with young people in your role. (eg social studies teacher, dean of students, coach, etc.)
Where do you call home?
Please share your racial identity. For example: mixed race; White; Asian; etc. (or prefer not to say).
Please share your gender identity. For example: female; nonbinary; etc. (or prefer not to say).
Media Release
By checking this box, you’re saying it’s okay for Citizen University to use photos, videos, or quotes of you in our materials. We might share your first name, but we’ll never share your contact info. These materials are always used to highlight your work and the impact of our programs.