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Current Mentor Questionnaire
Name
*
First
Last
Email
*
Enter Email
Confirm Email
Do you identify yourself as:
*
Select One
Deaf
Lated-Deafened
Hard of Hearing
Oral
Hearing
CODA
Other
Gender
*
Select One
Female
Male
They
Non-binary
Other
Prefer not to answer
Age
*
Select One
18-25
25-30
30-35
35-40
40+
What is your ethnicity?
*
Select One
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?
*
Select One
Part Time Employment
Full Time Employment
Unemployed- looking for work
Unemployed- not looking for work
Self-employed (freelance)
Student
Occupation
*
Select One
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?
*
Select One
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 opportunity?
*
Select One
School/Institution
Social Media
Friend
Other
Service: Other
*
What language do you speak/communicate fluently? (check all that apply)
*
English
ASL
Spanish
Italian
German
French
Mandarin
Other