RWDC Student Survey Sheet 2019/20

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School Name *

Team Name *

State *

States are listed in alphabetical order with territories below.

First (Given) name *

Last (Family) name *

Grade Level *

Gender *

Male

Female

In what type of community do you live? *

Urban/City

Suburbs

Rural

Please check if you are a member of groups usually underrepresented in science, technology, engineering, and math careers. (check those that apply)

African American

Hispanic

Asian

Native American or Pacific Islander

Other (This is not an identification of white or caucasian)

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