This free survey is powered by
Create a Survey
Surveys
2013
April
D
Demographics
Demographics
0%
Exit Survey
In what state do you live?
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Other
Are you male or female?
Male
Female
Which category below includes your age?
17 or younger
18-20
21-29
30-39
40-49
50-59
60 or older
Are you now married, widowed, divorced, separated, or never married?
Married
Widowed
Divorced
Separated
Never married
How many children age 17 or younger live in your household?
What is the highest level of school you have completed or the highest degree you have received?
Less than high school degree
High school degree or equivalent (e.g., GED)
Some college but no degree
Associate degree
Bachelor degree
Graduate degree
Which of the following categories best describes your employment status?
Employed, working 1-39 hours per week
Employed, working 40 or more hours per week
Not employed, looking for work
Not employed, NOT looking for work
Retired
Disabled, not able to work
What is your total household income?
Less than $20,000
$20,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 or More
To which racial or ethnic group(s) do you most identify?
White
Black or African-American
American Indian or Alaskan Native
Asian
Native Hawaiian or other Pacific Islander
From multiple races
Some other race
How often do you participate in fitness activity?
Once a week
Twice a week
3 times a week
4 times a week
5 times a week
6 times a week
7 times a week
Once a month
Once every 3 months
Rarely
Loading...
close
Loading...
Close
qpweb2.questionpro.net