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Self-Identification Questions

a)     Are you Francophone?

Yes                No                  I do not wish to answer

b)     Do you consider yourself to be an Indigenous person? (select all that apply)

First Nations, Status Indian, Non-Status Indian
Inuk (Inuit)
Métis
Other – Specify ____________________________
No, not an Indigenous person
I do not wish to answer

c)     Which of the following best describes your racial or ethnic identity? (select all that apply)

Arab
Black
Chinese
Filipino
Japanese
Korean
Latin American
South Asian (e.g. East Indian, Pakistani, Sri Lankan, etc.)
Southeast Asian (e.g. Vietnamese, Cambodian, Laotian, Thai, etc.)
West Asian (e.g. Iranian, Afghan, etc.)
White
Other – Specify ____________________________
I do not wish to answer

d)     What is your religion or creed? (select all that apply)

Atheist
Buddhist
Hindu
Jewish
Muslim
Protestant
Roman Catholic
Other Christian, such as Eastern Orthodox and Ukrainian Catholic
Sikh
Other religion – Specify ____________________________
No religion
I do not wish to answer

e)     Are you a person with a disability?
Yes                No                  I do not wish to answer

f)      Are you transgender, transsexual, gay, lesbian or bisexual? (select all that apply)Transgender
Transsexual
Gay
Lesbian
Bisexual
Other - Specify ____________________________
No I do not wish to answer