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Religious Preference
 
Catholic
 
Protestant
 
Other Christian
 
Mormon
 
Jewish
 
Hindu
 
Buddhist
 
Atheist
 
Agnostic
 
Other
 

 
 
 
What is your gender?
 
Male
 
Female
 
Transgender

 
 
 
Employment Status: Are you currently…?
 
 
Employed for wages
 
Self-employed
 
Out of work and looking for work
 
Out of work but not currently looking for work
 
A homemaker
 
A student
 
Military
 
Retired
 
Unable to work

 
 
 
Marital Status: What is your marital status?
 
 
Single, never married
 
Married or domestic partnership
 
Widowed
 
Divorced
 
Separated

 
 
 
Ethnicity origin (or Race): Please specify your ethnicity.
 
 
White
 
Hispanic or Latino
 
Black or African American
 
Native American or American Indian
 
Asian / Pacific Islander
 
Other

 
 
 
Age
 
18-24 years old
 
25-34 years old
 
35-44 years old
 
45-54 years old
 
55-64 years old

 
 
 
Political Affiliation
 
Republican
 
Democrat
 
Tea Party
 
Green Party
 
Independent
 
None
 
Other
 

 
 
 
Education: What is the highest degree or level of school you have completed? If currently enrolled, highest degree received.
 
Some high school, no diploma
 
High school graduate, diploma or the equivalent (for example: GED)
 
Some college credit, no degree
 
Trade/technical/vocational training
 
Associate degree
 
Bachelor’s degree
 
Master’s degree
 
Professional degree
 
Doctorate degree