The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

sdjv9Q8SY3cmSYKHp8W82

Screening Survey

Welcome and thank you for your interest in Project PEACE and our Community Conversations!

Your contributions to this research project are very appreciated and will help us better understand transition experiences and employment for youth with IDD in our community.

We want to make sure that you are comfortable sharing your voice in our community
conversation. By completing this short survey, we will get you the correct documents to help decide if you want to participate in recorded conversations about our community.

Please answer the questions honestly and to the best of your ability.

Thank you again for your time and consideration for participating in Project PEACE!

Which of the following best describes your role as it relates to Project PEACE?
"I am a..."

* must provide value

Youth with an intellectual/developmental disability

Parent/family member of youth with an intellectual/developmental disability

School personnel/educator

Professional at an advocacy organization

Professional at a Virginia agency

Provider

Business Representative

Community Leader

Project PEACE team member

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Thank you for starting your registration for Community Conversations!

If you would like someone on the Project PEACE team to help you complete this registration survey, click "Yes". If you would like to complete this survey on your own, click "No".

* must provide value

Yes

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You have indicated that you would like someone from the Project PEACE team to help you complete this registration survey.
We can help you register by meeting online through Zoom!
Please write your email address below (an email address that you use often) and we will contact you to schedule a time to register.

Thank you for your interest in Project PEACE! We look forward to working with you!

(After listing your email, you may end this survey).

* must provide value

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Thank you for giving us your email! We will contact you soon to schedule a time to complete this registration survey together.
Click "Finish" to leave this survey now.

* must provide value

Finish

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What is your relation to a family member with an intellectual/developmental disability?

* must provide value

Parent/Guardian

Grandparent

Sibling

Aunt/Uncle

Other family member

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What is your current age?

* must provide value

13 or under

23 or above

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What is your school division?

* must provide value

What is your current position within Colonial Heights Public Schools?

* must provide value

If your position within Colonial Heights Public Schools was not listed, please state your position here.

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What is the name of the organization/agency/business you represent?

* must provide value

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Describe your current role within this organization/agency/business.

* must provide value

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What are your pronouns?

She/Her

He/Him

They/Them

She/They

He/They

Not listed

Prefer not to say

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If your pronouns were not listed, what are they?

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What is your race?

Indigenous/Native

Asian

Black

Hispanic/Latinx

Pacific Islander

White

Biracial

Multiracial

Not listed here

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If not listed, what is your race?

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What is your age?

* must provide value

under 18

18-25

26-35

36-45

46-55

56-65

66 or older

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What is your email address? (please use an email address that you check regularly as we will send all study communications to this address)

* must provide value

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If you would like to receive text reminders about Community Conversations, please enter your cell phone number below.

I understand that by participating in Community Conversations, I am eligible to receive a gift card. To receive this gift card, I understand that I will need to provide additional information to the research team, including my name, Social Security Number, my home address, and phone number. By clicking "Agree" below, I acknowledge these requirements for receiving compensation. If I choose to disagree to sharing this personal information, I understand that I may not be compensated for my participation.

* must provide value

Agree

Disagree

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Please provide today's date (Month-Day-Year).

M-D-Y

Please provide your legal first and last name.

* must provide value

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What is your street address? (ex. 184 Main St.)

* must provide value

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City?

* must provide value

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State?

* must provide value

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Zip code?

* must provide value

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Please provide your Social Security number.

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If you choose not to provide your social security number to receive compensation for this study, please provide an explanation for not sharing your social security number.
If you did state your social security number above, you may disregard this question.

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Thank you for registering for Project PEACE Community Conversations at Colonial Heights! Your name has been recorded. Please select "continue" to finalize your registration.

Continue

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.