$500 Study

Question Title

* 1. Contact Info

Name

Phone

E-mail

Gender

Age

State

Country

Question Title

* 2. This study will take place over zoom. Do you have a laptop or desktop WITH a webcam that van be used for this study?

yes, PC

yes, MAC

yes, Chromebook

No, i want to use my tablet

no, i want to use my smartphone

no, i want to do the study without one

Question Title

* 3. What is your ethnic background?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 4. What is your highest level of education completed? Select one.

Grade school (8 years or less)

Some high school

High school diploma or GED

Some college

Associate's degree

Bachelor's degree

Some graduate school

Master's degree or other advanced degree

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* 5. Do you identify with any of the following religions or belief systems? Select all that apply

Protestant

Catholic

Mormon

Jehovah’s Witness

Eastern Orthodox

Other Christian

Judaism

Buddhism

Muslim

Hinduism

Odinism/Asatru

Shinto

Unitarian/Universalist

Zoroastrianism [attention check – remove if selected]

Other non-Christian

Atheist

Agnostic

Unaffiliated

Question Title

* 6. Are you...

Married

Living With Significant Other/Partnered

Single

Divorced

Widowed

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* 7. Do you have children?

Yes, under 18

Yes, over 18

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* 8. What is your total annual household income?

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Between $100,000 and $150,000

Over $150,000

Question Title

* 9. Did you receive the Covid-19 Vaccine? (Not required - we need yes and no)

yes, 2 shots of either Moderna or Pfizer + Booster

yes, 2 shots of either Moderna or Pfizer but not the booster

yes, but only one shot of Moderna or Pfizer

yes, one shot of Johnson and Johnson

no, i have NOT received the Covid 19 vaccine