White Privilege Survey

Demographics

1. Gender?
        Male
        Female
        Other

2. If answer to Gender is “Other,” then please specify.

3. What is your age?
        Under 21
        21 – 25
        26 – 30
        31 – 35
        36 – 40
        Over 40

4. What is your ethnicity or race?
        African or Black
        Asian, Eastern
        Asian, Central
        Asian, Southern
        European or White
        Hispanic or Latino
        Middle Easterner
        Native American
        Other
        Do not know

5. If answer to Ethnicity/race is “Other,” then please specify.

6. What is your religious affiliation?
        Agnostic
        Anglican
        Atheist
        Baptist
        Buddhist
        Christian Orthodox
        Confuscist
        Church of Latter Day Saints
        Deist
        Episcopalian
        Greek Orthodox
        Hindu
        Jew
        Lutheran
        Methodist
        Muslim, Shi'a
        Muslim, Sunni
        New Age
        Pagan
        Pentacostal
        Presbyterian
        Roman Catholic
        Seventh Day Adventist
        Taoist
        Wicca
        Other
        Do not know

7. If answer to Religious affiliation is “Other,” then please specify.

8. What is your highest level of education?
        Elementary school
        High school
        High school graduate
        GED
        Some college
        Associate's degree
        Baccalaureate degree
        Master's degree
        ABD
        Ph.D
        EEd
        Other