Interest Survey: Research on School Policing and Surveillance

1

Name

First Name

Last Name

2

Email

example@example.com

3

Are you 18 years or older? * This field is required.

YESNO

5

Ethnicity (e.g. African American, Afro-Latinx, Nigerian American)

7

Pronouns (e.g. she/they)

8

Year you graduated high school (e.g. 2016)

9

School District(s) Attended in High School

10

How did you hear about this research study? * This field is required.Please write the name of the person who referred you, or where (e.g. LinkedIn) you learned about they study.

11

Please write anything further you'd like me to know before our interview (optional)