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Initials of First and Last Name (Appreciated, but Not Required)
Initial of First Name : 
Initial of Last Name : 
 
 
 
What is your age?
 
0-17 Years
 
18-25 Years
 
26-35 Years
 
36-45 Years
 
46-55 Years
 
56-65 Years
 
66 Years or over
 
Decilne to Answer
 
 
 
 
What is your gender?
 
Male
 
Female
 
Decline to Answer
 
Other
 
 
 
 
What is the Highest Level of Education You Have Achieved?
 
Grade School (Grades K-8)
 
High School (Grades 9-12)
 
Technical / Vocational School
 
Some College
 
Associate (2 Year Degree)
 
Bachelor / Undergraduate (4 Year Degree)
 
Master's / Graduate
 
PhD / Doctorate
 
Other
 
 
 
 
Are you currently employed?
 
Yes
 
No
 
Other
 
 
 
 
What is your profession?
   
 
 
 
How would you rate the health of the United States economy?
 
Unacceptable
 
Very Poor
 
Poor
 
Below Average
 
Average
 
Above Average
 
Good
 
Very Good
 
Excellent
 
Other
 
 
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