16th Street J Parenting Center Survey

1. Part I: Information about the survey participant

	0-6 months	6-12 months	1-2 years	2-3 years	3-4 years	4-5 years	5+	N/A
Age of Child #1	*Age(s) of your Child(ren) Age of Child #1 0-6 months	Age of Child #1 6-12 months	Age of Child #1 1-2 years	Age of Child #1 2-3 years	Age of Child #1 3-4 years	Age of Child #1 4-5 years	Age of Child #1 5+	Age of Child #1 N/A
Age of Child #2	Age of Child #2 0-6 months	Age of Child #2 6-12 months	Age of Child #2 1-2 years	Age of Child #2 2-3 years	Age of Child #2 3-4 years	Age of Child #2 4-5 years	Age of Child #2 5+	Age of Child #2 N/A
Age of Child #3	Age of Child #3 0-6 months	Age of Child #3 6-12 months	Age of Child #3 1-2 years	Age of Child #3 2-3 years	Age of Child #3 3-4 years	Age of Child #3 4-5 years	Age of Child #3 5+	Age of Child #3 N/A
Age of Child #4	Age of Child #4 0-6 months	Age of Child #4 6-12 months	Age of Child #4 1-2 years	Age of Child #4 2-3 years	Age of Child #4 3-4 years	Age of Child #4 4-5 years	Age of Child #4 5+	Age of Child #4 N/A
Age of Child #5	Age of Child #5 0-6 months	Age of Child #5 6-12 months	Age of Child #5 1-2 years	Age of Child #5 2-3 years	Age of Child #5 3-4 years	Age of Child #5 4-5 years	Age of Child #5 5+	Age of Child #5 N/A

Neighborhood you live in: 16th Street Corridor (DC)

Adams Morgan

Arlington/Alexandria

Capitol Hill

Chevy Chase/Bethesda

Chinatown

Cleveland Park

Columbia Heights

Dupont Circle

Kalorama

Logan Circle

Mount Pleasant

Other DC

Other MD

Other VA

SW Waterfront

Takoma Park/Silver Spring

Van Ness/Tenleytown/Chevy Chase DC

Woodley Park

	Myself	My partner
Take care of child(ren) full-time	*How would you best describe your work situation and that of your partner (if applicable)? Select one from each column. Take care of child(ren) full-time Myself	Take care of child(ren) full-time My partner
Work outside the home part-time	Work outside the home part-time Myself	Work outside the home part-time My partner
Work outside the home full-time	Work outside the home full-time Myself	Work outside the home full-time My partner
N/A	N/A Myself	N/A My partner

Other (please specify)