Screener for UX School Project Name Email 1. What is your age range? 18-35 36-50 51-70 None of the Above None 2. In which country do you reside? 3. What is your ethnicity? (Check all that apply) Caucasian or European-American Black or African-American Native American Indian or Native American Alaskan Asian Native Hawaiian or other Pacific Islander Hispanic or Latino Other Decline to Answer 4. What is your gender? 5. List any disabilities you feel comfortable sharing (optional) 6. Which of the following interests you? (Please check all interests listed) Art Baking/Cooking Reading Nonfiction Reading Fiction Astronomy History News or Current Events Native Americans & Cowboys Beer or Wine Tasting Jewelry Making Genealogy Sports Music Writing Movies Historical Reenactments & Plays Fashion Museums or Galleries Architecture Gardens Time's up
