Research Participant Application Form

Research Participant Application Form

Please fill out this form to apply as a participant in our research study.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number. This will only be used to contact you in case of emergency scheduling needs.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Birth Date

MonthDayYear
Gender

Other
Are you between 1/4 and 3/4 Korean American?
Please describe the ethnicity of your parents. Be as specific as possible. (For example: My father's ethnicity is English, Scottish, and Native American. My mother's ethnicity is Korean.)
If you do not know the ethnicity of one of your parents, please provide what information you have.
Do you have high speed internet connectivity that will allow you to attend sessions over Zoom with your camera on?
Please describe your experience and comfort with making art and crafts. (For example: I enjoy taking group pottery classes when I have the time OR I rarely get to make art and when I do, I am not confident in the final product).
Your art making skill will NOT disqualify you from participating.