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What is your age?
 
18-19
 
19-20
 
21-22
 
22-23
 
 
 
What is your gender?
 
Female
 
Male
 
 
 
What is your sexual orientation (Select all that apply)?
 
Gay
 
Lesbian
 
Straight
 
Bisexual
 
Pansexual
 
Queer
 
Other

 
 
 
What is the highest level of education you have completed?
 
Grammar school
 
High school or equivalent
 
Vocational/technical school (2 year)
 
Some college
 
Bachelor's degree
 
Master's degree
 
Doctoral degree
 
Professional degree (MD, JD, etc.)
 
Other
 
 
 
 
How would you classify yourself?
 
Arab
 
Asian/Pacific Islander
 
Black
 
Caucasian/White
 
Hispanic
 
Indigenous or Aboriginal
 
Latino
 
Multiracial
 
Would rather not say
 
Other
 
 
 
 
What is your current marital status?
 
Divorced
 
Living with another
 
Married
 
Separated
 
Single
 
Widowed
 
Would rather not say
 
 
 
What is your height?
 
4'6 - 4'9
 
5' - 5'3
 
5'4 - 5'7
 
5'8 - 6'1
 
6' - 6'+
 
 
 
What is your weight? 
 
100 - 110 lbs.
 
111 - 121 lbs.
 
122 - 132 lbs.
 
133 - 143 lbs.
 
144 - 154 lbs.
 
155 - 165 lbs.
 
166 + lbs.
 
 

How frequently do you access the web from the following places?
Daily Weekly Monthly Less than once a month Never
From home (including a home office)
From work
From school
From a public terminal (e.g. library, cybercafe, etc.)
From other places