Gender Female

Male

How old are you? 21 and Under

22 to 34

35 to 44

45 to 54

55 to 64

65 and Over

Which of these best describes your ethnic background? African American/Black

Asian

Caucasian/White

Hispanic

Native American

Other

Other (please specify)

What is the highest level of education that you have achieved? Less than high school

High school/GED

Some college

Associates degree

Bachelors degree

Graduate or Professional Degree