STP Demographics
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1
. First your basic information:
First your basic information:
Name:
City/Town:
Email Address:
Phone Number:
2
. Do you live
Do you live
"in town"
"in the country"
3
. Transportation needs:
Transportation needs:
Own car & can provide transportation
One vehicle family & would need some rides occasionally
Currently not driving and rely on rides from others
4
. What year were you born?
What year were you born?
5
. Your marital status is:
Single
Married
Separated
Divorced
Widowed
Your marital status is:
6
. If married, your spouse's name?
If married, your spouse's name?
7
. Please list the ages of children in the home ages 18 or younger - please one parent per household, so children won't be counted twice.
Please list the ages of children in the home ages 18 or younger - please one parent per household, so children won't be counted twice.
N/A
Boy
Girl
8
. Which description best describes you?
Which description best describes you?
Full time employment
Part time employment
Unemployed & looking for a job
Self-employed
Retired
Disabled
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