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What is your age?
 
25 or under
 
26-40
 
41-55
 
56 or older
 
 
 
What is your gender?
 
Female
 
Male
 
 
 
What is your primary language?
 
English
 
Arabic
 
Spanish
 
French
 
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 household income in U.S. dollars?
 
Under $10,000
 
$10,000 - $19,999
 
$20,000 - $29,999
 
$30,000 - $39,999
 
$40,000 - $49,999
 
$50,000 - $74,999
 
$75,000 - $99,999
 
$100,000 - $150,000
 
Over $150,000
 
Would rather not say
 
 
 
Which of the following best describes the area you live in?
 
Urban
 
Suburban
 
Rural
 
 
 
Which of the following categories best describes your primarily area of employment (regardless of your actual position)?
 
Homemaker
 
Retired
 
Student
 
Unemployed
 
Agriculture, Forestry, Fishing, or Hunting
 
Arts, Entertainment, or Recreation
 
Broadcasting
 
Education - College, University, or Adult
 
Education - Primary/Secondary (K-12)
 
Education - Other
 
Construction
 
Finance and Insurance
 
Government and Public Administration
 
Health Care and Social Assistance
 
Hotel and Food Services
 
Information - Services and Data
 
Information - Other
 
Processing
 
Legal Services
 
Manufacturing - Computer and Electronics
 
Manufacturing - Other
 
Military
 
Mining
 
Publishing
 
Real Estate, Rental, or Leasing
 
Religious
 
Retail
 
Scientific or Technical Services
 
Software
 
Telecommunications
 
Transportation and Warehousing
 
Utilities
 
Wholesale
 
Other
 
 
 
 
Which of the following best describes your role in industry?
 
Upper management
 
Middle management
 
Junior management
 
Administrative staff
 
Support staff
 
Student
 
Trained professional
 
Skilled laborer
 
Consultant
 
Temporary employee
 
Researcher
 
Self-employed
 
Other
 
 
 
 
The organization you work for is in which of the following:
 
Public sector
 
Private sector
 
Not-for-profit
 
Don't know
 
Other
 
 
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