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Name
*
First
Last
Email
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Do you identify yourself as:
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Deaf
Lated-Deafened
Hard of Hearing
Oral
Hearing
CODA
Other
Gender
*
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Female
Male
They
Non-binary
Other
Prefer not to answer
Age
*
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18-25
25-30
30-35
35-40
40+
What is your ethnicity?
*
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Black or African American
Asian/Pacific Islander
Native American or American Indian
White/Caucasian
Biracial
Other
Prefer not to answer
Where do you live?
City
State / Province / Region
Employment?
*
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Part Time Employment
Full Time Employment
Unemployed- looking for work
Unemployed- not looking for work
Self-employed (freelance)
Student
Occupation
*
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Freelance Interpreter
Interpreter for agency or K-12
Student -Interpreting Major Interpreting Training Program (ITP)
Student- ASL/Deaf Studies major
Student- ASL/Deaf Studies minor
Intern
Other
Occupation: Other
*
What is the highest degree or level of education you have completed?
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High School Diploma
Vocational/Training School or Program
College Degree
Graduate Degree
Other
Level of Education: Other
*
Name of the Institution you are currently attending or graduated from.
*
How did you find out about this service?
*
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School/Institution
Social Media
Friend
Other
Service: Other
*
Are you looking for a mentor to:
*
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Learn ASL
Learn more about Deaf Culture
Improve your ASL skills in general
Improve your ASL skills for interpreter certification
Other
Mentor: Other
*
What language do you speak/communicate fluently? (check all that apply)
*
English
ASL
Spanish
Italian
German
French
Mandarin
Other
How did you learn ASL?
*
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At Community College/University Classes
ASL classes at non-profit agency
Family member
Friend
Other
How did you find out about ASL Mentors?
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Social Media
Colleague/Friend
College/University
Non-profit agency/organization
Other
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