BEC Scholarship 2022 Recipient Survey

BEC Scholarship 2022 Recipient Survey

Congratulations on being selected to receive a BEC Scholarship. Please help us compile the demographics of our recipients by completing the following survey.
Enter your last name *
What is your gender? *

Female Male
Which race/ethnicity best describes you? (Please choose only one.) *

American Indian or Alaskan Native Asian / Pacific Islander Black or African American Hispanic White / Caucasian Multiple ethnicity / Other (please specify) Other
Please indicate which high school you will graduate from this year. *
Please indicate which college you will attend in the fall? *
What will be your major? *
Did you grow up in a one or two-parent household? *

Single Parent Household Two-Parent Household Other
Are you the first or second in your family to attend college? *

Yes No Other- Please Specify
Did you receive a full scholarship from the college you will be attending? *

Yes No
Do you have any physical or learning disabilities? *

Yes No
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform