City State Zip Code Borough Home Phone Email Gender Response Female Male No Date of Birth Hispanic/Latino Not Ethnicity Hispanic/Latino No Response American Indian or Alaskan Native American Black/African Race Native Hawaiian/Pacific Islander Response White Other No Country Primary of Origin Language English Additional Yes No Proficient Language(s) Student Participant is a student If yes: Full-time Status School Student ID / Public Type OSIS # School MS 447 School 345 Dean Street Brooklyn NY 11217 Name Address Teacher/ Current Advisor Grade Level
City State Zip Code Borough Home Phone Email Gender Female Male No Response Date of Birth Ethnicity Hispanic/Latino Not Hispanic/Latino No Response Race American Indian or Alaskan Native Black/African American Native Hawaiian/Pacific Islander White Other No Response Country of Origin Primary Language English Proficient Yes No Additional Language(s) Student Status Participant is a student If yes: Full-time School Type Public Student ID / OSIS # School Name MS 447 School Address 345 Dean Street Brooklyn NY 11217 Teacher/ Advisor Current Grade Level