1. Demographics

Please answer whichever questions you feel comfortable answering. None of this information will be shared or sold without your permission.

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* 1. First Name

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* 2. Last Name

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* 3. Business Name (for Business membership only)

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* 4. Email addresses:

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* 5. Phone numbers:

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* 6. Address

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* 7. City

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* 8. State

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* 9. Zip

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* 10. Birthdate

Date

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* 11. What is your gender?

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

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

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

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* 15. Which of the following best describes your current occupation?

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 33% of survey complete.

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