Youth Inquiry

Mailing Street Address

Mailing City

Mailing State

Mailing Zip Code

Parish:

Gender	Personal Pronouns
How does the youth identify?	What pronouns does the youth use?
School	Graduation Year from High School This is the year the youth will graduate.

American Indian or Alaska Native	Asian Indian
Black or African American	Chamorro
Chinese	Filipino
Hispanic - Cuban	Hispanic-Mexican,MexicanAmerican,Chicano
Hispanic-Other Latinx or Spanish origin	Hispanic - Puerto Rican
Japanese	Korean
Middle Eastern or North African	Native Hawaiian
Other	Other Asian
Other Pacific Islander	Prefer not to say
Samoan	Some other race or origin
Vietnamese	White or Caucasian