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Exit Survey
 
 
Age:
 
21-25
 
26-30
 
31-40
 
41-50
 
51-60
 
61 or over
 
Prefer not to disclose
 
 
Gender:
 
Female
 
Male
 
Prefer not to disclose
 
 
 
Language(s) spoken: (check as many as apply)
 
English
 
Spanish
 
Cantonese Chinese
 
Mandarin Chinese
 
French
 
German
 
Other
 

 
 
How would you describe your cultural background?
   
 
 
Race & Ethnicity: (check as many as apply)
 
American Indian
 
Alaska Native
 
Asian
 
Black or African American
 
Latino or Hispanic
 
Native Hawaiian or Pacific Islander
 
White
 
Prefer not to disclose
 
Other
 

 
 
 
Were you born in the U.S.?
 
Yes
 
No
 
Prefer not to disclose
 
 
If not, how long have you been in the U.S.?
   
 
 
 
Total number of years teaching:
   
 
 
Number of years teaching preschool:
   
 
 
Number of years at current preschool: