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How old are you?
 
13 or younger
 
14 or older
 
 
 
What race/ethnicity are you?
 
American Indian or Alaska Native
 
Asian
 
Black or African American
 
Native Hawaiian or other pacific Islander
 
White non-latino
 
White latino
 
 
 
Gender
 
Male
 
Female
 
 
 
What language do you speak?
 
English
 
Spanish
 
Both
 
Other
 
 
 
Are you a U.S. citizen?
 
Yes
 
No
 
 
 
How long have you been in the U.S.?
 
Less than 6 months
 
6 months -1 year
 
1 year- 2 years
 
2 years- 3 years
 
3 years- 4 years
 
More than 4 years
 
 
 
What brought you to the United States?
 
Poverty
 
Violence
 
Reunification
 
Work
 
Other
 
 
 
Have you ever been asked to do "sexual favors?"
 
Yes
 
No
 
 
 
Do you owe any money to anyone?
 
Yes
 
No
 
 
 
Have you ever been affiliated with a gang member(s)?
 
Yes
 
No