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$500 Study
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1.
Contact Info
(Required.)
Name
Phone
E-mail
Gender
Age
State
Country
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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?
(Required.)
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
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3.
What is your ethnic background?
(Required.)
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.
(Required.)
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
(Required.)
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
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6.
Are you...
(Required.)
Married
Living With Significant Other/Partnered
Single
Divorced
Widowed
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7.
Do you have children?
(Required.)
Yes, under 18
Yes, over 18
no
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8.
What is your total annual household income?
(Required.)
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
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9.
Did you receive the Covid-19 Vaccine? (Not required - we need yes and no)
(Required.)
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
Current Progress,
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