LEIMAY Community Demographics Survey

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Why Do we Ask Your Demographic Information?

Why demographics? Historically, organizations like LEIMAY have gone and remained underfunded due to a myriad of reasons. As a small non-profit organization, one of the ways in which we can have access to resources is by applying for grants to government agencies and private foundations. In the past, our applications have not been competitive enough due to our lack of data collection of the communities we serve. As we continue to work towards accessing funds to our programs, we ask you to please help us by answering the questions below. The information you provide will remain anonymous in any application or reporting.

Please note that every question is optional, including the assigning of your name to your response.

First Name

Last Name

Phone

Zip Code

Borough

Council Member

Find your Council Member: https://council.nyc.gov/districts/

Which is your role in the LEIMAY Community?

Team

Ensemble

Artist

Student

Board

Other:

What age group do you fall into?

80s

70s

60s

50s

40s

30s

20s

Under 20

Prefer not to answer

Clear selection

What racial/ethnic groups do you belong to? (Please select all that apply)

Black, African or Caribbean

Hispanic/Latino

Native Hawaiian or Pacific Islander

Native American

Middle Eastern

East Asian

South Asian

White or of European Descent

Two or more races

Prefer not to answer

Other:

How do you describe your gender identity?

DEFINITIONS: Cisgender individuals have a sense of personal identity or gender that corresponds with their birth sex. Transgender individuals have a sense of personal identity or gender that does not correspond with their birth sex.

Cisgender Female

Cisgender Male

Transgender Female

Transgender Male

Transgender Person

Non-Binary or Gender Neutral

Two-Spirit

Prefer not to answer

How do you describe your sexual orientation?

Asexual

Bisexual

Gay

Straight (Heterosexual)

Lesbian

Pansexual

Queer

Questioning or unsure

Prefer not to answer

Other:

What are your pronouns?

She/Her/Hers

He/Him/His

They/Them/Theirs

Prefer not to answer

Other:

Do you identify as a person with a disability or a person with accessibility needs?

As a person with hearing difficulty

As a person with vision difficulty

As a person with cognitive difficulty

As a person with ambulatory difficulty

As a person with difficulty with self care

As a person with independent living difficulty

I do not identify as a person with a disability or accessibility needs

Prefer not to answer

Other:

If you have a religious identity or affiliation, would you share that affiliation?

Are there other identifying factors you would like to share that we haven't asked about?

Feedback

Recognizing the delicate nature in the underlying fabric of the collection of demographic information, we welcome feedback in understanding how to better our approach to language in this practice.

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