Demographic Information Sheet



Demographic Information Form

Instructions: Please provide a response for each of the following questions:

1. What is your age? __________

2. What is you sex?

Female ( Male (

3. What is your marital status?

Single ( Married ( Separated ( Divorced ( Widowed (

4. What is your annual income (or combined annual income if you have a spouse)?

Less than $60,000 ( $60,001 to $70,000 ( $70,001 to $80,000 (

$80,001 to $90,000 ( $90,001 to $100,000 ( Greater than $100,000 (

5. With which racial or ethnic category do you identify?

African American ( Asian/Pacific Islander ( Caucasian ( Latino (

Other: ____________________

6. With what denomination or faith tradition do you most closely identify?

______________________________________________________________________

7. How long have you been employed as a tenure-track faculty member at Pepperdine? __________

8. What is your current academic rank?

Assistant Professor (

Associate Professor (

Full Professor (

Distinguished Professor (

9. To which school do you belong?

Graduate School of Education and Psychology (

Graziadio School of Business and Management (

School of Law (

School of Public Policy (

Seaver College (

10. Pepperdine sponsors several activities associated with the Lilly Voyage Project on vocation. Please list any of the activities associated with this project in which you have been involved.

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download