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By marking "yes" I am agreeing that I understand that completing this survey is voluntary and is only intended to gather my information for program eligibility purposes.
What is your Date of Birth?
What is your Gender
Prefer to self-describe
What is your Race/Ethnicity (select all that apply)
Asian (do you identify as: Hmong, Vietnamese, Chinese, Korean, etc-- please describe)
Hispanic or Latinx (do you identity as: Mexican, Cuban, Dominican, El Salvadorian, etc-- please describe)
Native Hawaiian/Pacific Islander
Provide your email, preferably UCR email.
If you have been assigned one, what is your UCR student identification number (SID)
What is your phone number?
What is your major? (it is fine to say "undecided")
What is your status?
I want to apply to UCR but I have not done so yet
I have applied to UCR but I have not heard if I am accepted
I have been accepted to UCR but I am not sure if I am going to say yes
I am an incoming first year student
I am an incoming transfer student
I am a current first year UCR student
I am a current second year UCR student
I am a current third year UCR student
I am a current fourth year or later UCR student
Were you in foster care for any period of time BEFORE the age of 13?
Were you in foster care for any period of time SINCE the age of 13?
Are you still in foster care?
Were you ever adopted, if so at what age?
Were you ultimately reunited with your biological parents, if yes at what age? If no, please briefly describe your placement history.
How many foster care placements did you have?
How old were you the first time you were placed into foster care?
How old were you the last time you were placed into foster care? N/A if you are still in.
If you were ever in foster care, which county heard your case (i.e., in which county were you considered a ward/independent of the court?)
Where were/will you be living before coming to UCR?
With one or more biological or adoptive parents
With a member of my extended family (e.g. aunt/uncle, grandparents)
With a sibling (i.e. sibling was your guardian or primary care provider)
With one or more foster parents
In a group home or other residential facility
Do you/are you eligible to receive Chafee? (Chafee is a California state grant awarded to a subset of foster youth and would appear on your financial aid award).
Do you/are you eligible to receive AB12 (AB12 is a California policy that extends foster care benefits to age 21, sometimes it is also called extended foster care-- EFC)?
Who do you spend the holidays with?
Do you currently have a social worker?
Do you have a copy of your "ward of court" document?
Please provide any other important information we should know about you.
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