Demographic Information

50% of survey complete.

* 1.  Where do you live?

* 2. What is your age?

* 3. How many people live in your household?

* 4. Tell us about the make up of your household, do any of the following apply:

  Yes No
You have children under the age of 10 living in your household
You have children between the age of 10 and 18 living in your household
You have adults over the age of 65 living in your household