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* 1. Contact Information

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* 2. What is your nearest metro area?

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* 3. What is your gender?

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* 4. How old are you?

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* 5. What  is your ethnic background?

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* 6. What language do you speak most often in your home?

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* 7. Including yourself, how many people currently live with you in your household?

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* 8. How many children under the age of 18 currently live in your household?

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* 9. What is the total yearly income for your entire household (e.g., meaning the total income of everyone that lives in your home, including any earnings that are not income from work), before taxes?

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* 10. Have you received SNAP or CalFresh benefits to help with your food expenses within the last 12 months?

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* 11. By working hard, a person can overcome the obstacles that life presents. 
choices.

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* 12. I prioritize the happiness of those close to me over my own.

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* 13. I go out of my way to help those who are suffering or underprivileged.

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* 14. It is important that I make smart choices to keep myself safe.

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* 15. I like to explore unfamiliar places by myself, even if it means getting lost.

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