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INSTRUCTIONS: Step Forward Michigan Video
Please complete the following short survey. Once you complete the survey you will recieve a confirmation and a link to the Step Forward Michigan Video.
MSU Extension Program Participant Demographic Data Collection Form
MSU Extension programs are open to everyone. We are required, for Civil Rights reasons, to report program participant race and gender data to the United States Department of Agriculture (USDA). Providing the following race and gender information is voluntary and will be maintained strictly for reporting purposes. These records are kept separately from mailing lists and other participant information. Only the race and gender data is reported to the USDA. Participant names are not reported. Thank you for taking the time to provide us with this information.
Race/Ethnicity:
American Indian/Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern/Arab-American
Native Hawaiian or Other Pacific Islander
Caucasian/White
Multi-Racial (two or more races)
Choose not to provide
Optional: Area/country of origin:
Gender:
Female
Male
Choose not to provide
County of residence:
Out of State
Alcona
Alger
Allegan
Alpena
Antrim
Arenac
Baraga
Barry
Bay
Benzie
Berrien
Branch
Calhoun
Cass
Charlevoix
Cheboygan
Chippewa
Clare
Clinton
Crawford
Delta
Dickinson
Eaton
Emmet
Genesee
Gladwin
Gogebic
Grand Traverse
Gratiot
Hillsdale
Houghton
Huron
Ingham
Ionia
Iosco
Iron
Isabella
Jackson
Kalamazoo
Kalkaska
Kent
Keweenaw
Lake
Lapeer
Leelanau
Lenawee
Livingston
Luce
Mackinac
Macomb
Manistee
Marquette
Mason
Mecosta
Menominee
Midland
Missaukee
Monroe
Montcalm
Montmorency
Muskegon
Newaygo
Oakland
Oceana
Ogemaw
Ontonagon
Osceola
Oscoda
Otsego
Ottawa
Presque Isle
Roscommon
Saginaw
Saint Clair
Saint Joseph
Sanilac
Schoolcraft
Shiawassee
Tuscola
Van Buren
Washtenaw
Wayne
Wexford
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