890 DB OK TV Questionnaire - Oct 2016 Question Title * 1. What's your first name? Question Title * 2. What's your last name? Question Title * 3. E-Mail Address Question Title * 4. Phone number to reach you Question Title * 5. City and state you live in City State Question Title * 6. What's your age? Question Title * 7. What is your height Feet Inches Question Title * 8. What is your household income level? Less than $30,000 $30,000- $50,000 $50,000- $75,000 $75,000- $100,000 $100,000- $150,000 $150,000+ Prefer not to say Question Title * 9. Which of the following best describes your current relationship status? Married Widowed Divorced Separated In a domestic partnership or civil union Single, but cohabiting with a significant other Single, never married Question Title * 10. Do you have children? Yes No Question Title * 11. What is the highest level of education that you have completed? No formal education High school student High school Trade/technical/vocational school College (Bachelor’s Degree) University or above (Master’s or Doctoral Degree) Other (please specify) Next