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What is your gender?
 
Male
 
Female
 
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
 
What is your marital status?
Single (Never married) Married Domestic partnership Widowed Divorced Separated Don’t know
 
 
 
How many children do you have?
 
No Children
 
1 child
 
2 children
 
3 children
 
More than 3 children
 
 
 
What is the highest level of education you have achieved?
 
Less than high school degree
 
High school degree or equivalent (e.g. GED)
 
Some college but no degree
 
Associate degree (e.g. AA, AS)
 
Bachelor's degree (e.g. BA, AB, BS)
 
Master's degree (e.g. MA, MS, MBA)
 
Professional degree (e.g. MD, DDS, JD)
 
Doctorate degree (e.g. PhD)
 
 
 
How would you classify your socioeconomic status?
 
Lower class
 
Middle class
 
Upper middle class
 
Upper class
 
Other
 
 
 
 
What is your race and ethnicity (Select all that apply)?
 
White
 
Black or African American
 
Hispanic or Latino
 
Asian
 
American Indian or Alaska Native
 
Pacific Islander
 
Other
 

 
 
 
What is your current employment status?
 
Employed Part time
 
Employed Full time
 
Retired
 
Unemployed
 
Homemaker
 
Other
 
 
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