Electronic Device Study - Nationwide Question Title * 1. Full Name Question Title * 2. E-Mail Address Question Title * 3. Phone number to reach you Question Title * 4. What is your age? Question Title * 5. Where do you live? City State Question Title * 6. What is your current employment status? Working part time Working full time Not working, and looking for a new job Nor working, and not looking In school full time In school part time Retired Homemaker Other Question Title * 7. Which of the following best describes your ethnic background? Asian Black / African American Hispanic or Latino Native American White Prefer not to say Other (please specify) Question Title * 8. What is the highest level of education you have completed? No formal education High School Trade/Tech/Vocational School or some college Undergraduate Degree Graduate Degree Other (please specify) Question Title * 9. What is your marital status? I have a domestic partner I am married I am single/divorced Question Title * 10. Which of the following is true? I have kids I plan to have kids in the next 1-3 years I don't plan to have kids Question Title * 11. Are you head of your household? Yes No Question Title * 12. What is your annual household income before taxes? $0 - $19,999 $20,000 - $49,999 50,000 - $69,999 $70,000 - $99,999 $100,000 or more Prefer not to answer Next