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Scholarship Recipient Survey: End of Semester 1

Thank you for completing the following survey. This information will be used to improve the CHW Certificate curriculum and our scholarship process for Fall 2024. The information in this form will be de-identified (all personal information removed) and shared with the Minnesota Community Health Worker Alliance Education Committee for the purpose of curriculum improvement and the Minnesota Department of Health and the Health Resources and Services Administration for the purpose of grant reporting. Your answers in this survey will not affect your ability to continue to receive the CHWTP scholarship; please be honest!

Scholarship Recipient Survey: End of Semester 1

Name(Required)
What is your race?(Required)
What is your Ethnicicy?(Required)
What is your gender?(Required)
Please select the cultural group that you identify with most:

Please select the languages that you speak/understand fluently(Required)
Please select the languages that you read fluently(Required)
How helpful would it be to your learning and success as a student to have course materials such as slide presentations, assignments, handouts, etc. in languages other than English?(Required)
Which of these translated course materials would be most helpful?(Required)

As a student, how important is it to have an empowering, engaging and culturally relevant learning environment?(Required)
This field is for validation purposes and should be left unchanged.