1) Are you Male or Female?

1. Male
2. Female

   

2) What is your age?

-- Select Here -- 18-21 22-25 26-30 31-40 41-50 51-60 61 or over

3) What is the highest level of education you have completed?

-- Select Here -- Less than High School High School/GED Some College 2-Year College Degree(Associates) 4-Year College Degree(BA,BS) Master's Degree Doctoral Degree Professional Degree(MD,JD)

4) What is your own yearly income?

-- Select Here -- Less than $10,000 $10,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$59,999 $60,000-$69,999 $70,000-$79,999 $80,000-$89,999 $90,000-$99,999 $100,000-$149,000 More than $150,000

5) What is your total household income, including all earners in your household?

-- Select Here -- Less than $10,000 $10,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,999 $50,000-$59,999 $60,000-$69,999 $70,000-$79,999 $80,000-$89,999 $90,000-$99,999 $100,000-$149,000 More than $150,000

6) What is your current marital status?

1. Divorced
2. Legally Separated
3. Married
4. Registered Domestic Partner
5. Separated
6. Single
7. Unmarried
8. Unreported
9. Widowed

   

7) What is your religious affiliation?

1. Protestant Christian
2. Roman Catholic
3. Evangelical Christian
4. Jewish
5. Muslim
6. Hindu
7. Other

    Other Religious Affiliation:

8) What is your race?

-- Select Here -- White White, non-Hispanic African-American Hispanic Asian-Pacific Islander Native American

9) What is the highest level of education your mother has completed?

-- Select Here -- Less than High School High School/GED Some College 2-Year College Degree(Associates) 4-Year College Degree(BA,BS) Master's Degree Doctoral Degree Professional Degree(MD,JD)

10) What is the highest level of education your father has completed?

-- Select Here -- Less than High School High School/GED Some College 2-Year College Degree(Associates) 4-Year College Degree(BA,BS) Master's Degree Doctoral Degree Professional Degree(MD,JD)