text only

Please Update Your Contact Info!

This information will only be used to contact you with information about or to administer the MNYTD survey if you have been selected as part of the MNYTD sample. We may also contact you with information regarding resources available for young adults. We will not share your contact information with any other organizations besides the MN Department of Human Services or use it for any other purposes.

Please include current information for yourself and for others that will know how to contact you. We know you may not have all of the requested information for everyone, so please complete as much as you can! Every bit helps! Thank you!

When you finish, you will be given the option to print all of your entries prior to submitting, to create an address book for yourself.

 
 
 Your birthday
 
 
 
 
 
 
 Do you have a text messaging plan?
 
 
 
 Social Networks                                                                    
 (Please check all that you use) 
 Facebook 
 
 Instagram 
 
 Twitter 
 
 WhatsApp 
 
 Snapchat 
 
 Other (please note) 
 
 
 
 
 

Please click the "Next" button below or your information will be lost!

 
Snap Survey Software