The following information is confidential and for research purposes only.

* 1. Are you male or female?

* 2. Which category below includes your age?

* 3. What is the highest level of school you have completed or the highest degree you have received?

* 4. Which of the following categories best describes your employment status?

* 5. How much total combined money did all members of your HOUSEHOLD earn in 2012? This includes money from jobs; net income from business, farm, or rent; pensions; dividends; interest; social security payments; and any other money income received by members of your HOUSEHOLD that are EIGHTEEN (18) years of age or older.

* 6. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

* 7. In what city do you live?