Short Social Capital Bench Mark Survey 1. Default Section Question Title * 1. What is your sex? Male Female Question Title * 2. Where did you hear about the 2012 Survey? (Required.) My student brought it home from school At the Grocery store At the Library At a Health Care Center (doctor's office, hospital etc.) At a Community Center (Southside etc.) From a friend I don't remember Other (please specify) Question Title * 3. Have you ever taken the Social Capital Survey before? Yes I don't think so Definitely No I don't remember Question Title * 4. Generally speaking, would you say that most people can be trusted or that you can't be too careful in dealing with people? People can be trusted You can't be too careful Don't know Question Title * 5. Generally speaking, how much can you trust people in your neighborhood? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 6. Generally speaking, how much can you trust the police in your community? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 7. Generally speaking, how much can you trust people who work in the stores where you shop? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 8. Generally speaking, how much do you trust White people? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 9. General speaking, how much can you trust African Americans or Blacks? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 10. Generally speaking, how much can you trust Hispanics or Latinos? Trust them a lot Trust them some Trust them only a little Trust them not at all Question Title * 11. How interested are you in politics and national affairs? Very interested Somewhat interested Only slightly interested Not at all interested Question Title * 12. Are you currently registered to vote? Yes No Question Title * 13. How much of the time do you think you can trust the national government to do what is right? Just about always Most of the time Some of the time Hardly ever Question Title * 14. How much of the time do you think you can trust your local government to do what is right? Just about always Most of the time Some of the time Hardly ever Question Title * 15. Thinking politically and socially, how would you describe your own general outlook. Very conservative Moderately conservative Middle-of-the-road Moderately liberal Very liberal Question Title * 16. How many times in the past twelve months have you worked on a community project? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 17. How many times in the past twelve months have you donated blood? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 18. How many times in the past twelve months have you attended any public meeting in which there was discussion of town or school affairs? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 19. How many times in the past twelve months have you attended a political meeting or rally? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 20. How many times in the past twelve months have you attended any club or organizational meeting? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 21. How many times in the past twelve months have you had friends over to your home? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 22. How many times in the past twelve months have you been in the home of a friend of a different race or had them in your home? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 23. How many times in the past twelve months have you been in the home of someone of a different neighborhood or had them in your home? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 24. How many times in the past twelve months have you been in the home of someone you consider to be a community leader or had one in your home? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 25. How many times in the past twelve months have you volunteered? never did this once a few times 2-4 times 5-9 times about once a month on average twice a month about once a week on average more than once a week Question Title * 26. In the past twelve months, have you served as an officer or served on a committee of any local club or organization? Yes No Question Title * 27. Not including weddings and funerals, how often do you attend religious services? Every week or more often Almost every week Once or twice a month A few times per year Less often than that Never Question Title * 28. During the past 12 months, approximately how much money did you and the other family members in your household contribute to secular causes and religious causes, including your local religious congregation? None Less than $100 $100-$500 $500-$1,000 $1,000-$5,000 More than $5,000 Question Title * 29. All things considered, how happy are you? Very happy Happy Not very happy Not happy at all Question Title * 30. How would you describe your overall state of health? Excellent Very good Good Fair Poor Question Title * 31. Is television your primary form of entertainment? Agree strongly Agree somewhat Disagree somewhat Disagree strongly Question Title * 32. Are you a student? Yes No Question Title * 33. Are you permanently disabled? Yes No Question Title * 34. What is your current employment situation? Working Temporarily laid off Unemployed Retired Housemaker Question Title * 35. What year were you born? Year: Question Title * 36. What is the highest grade of school or year of college you have completed? Less than high school (Grade 11 or less) High school diploma (including GED) Some college Associates degree (2 years) or specialized technical training Bachelor's degree Some graduate training Graduate or professional degree Question Title * 37. Do you consider yourself Hispanic or Latino? Yes No Question Title * 38. If you answered yes to the previous questions, would you say your background is Mexican, Puerto Rican, Cuban, or something else? Mexican Puerto Rican Cuban Other Not Hispanic or Latino Question Title * 39. Do you consider yourself to be White or Black? Yes No Question Title * 40. How do you self identify? White Middle Eastern European African American or Black Asian or Pacific Islander Alaskan Native/Native American Hispanic Latino Other Question Title * 41. If you consider yourself to be Asian, what would you say your background is? Chinese Korean Japanese Filipino Something else Not Asian Question Title * 42. Are you a citizen of the United States of America? Yes No Question Title * 43. How many different telephone numbers does your household have, not counting those dedicated to a fax machine or computer? 0 1 2 3 4 5 6+ Question Title * 44. If you added together the yearly incomes, before taxes, of all the members of your household for last year, 2009, what would the total be? $20,000 or less Over $20,000 but less than $30,000 $30,000 - $50,000 $50,000 - $75,000 $75,000 - $100,000 $100,000 or more Question Title * 45. Which city, village or town do you live in? Ithaca (Town) Ithaca (City) Dryden Caroline Danby Enfield Groton Lansing Newfield Ulysses Other Question Title * 46. What is your current marital status? Currently married Separated Divorced Widowed Partnered Never Married Question Title * 47. How many children, aged 17 or younger, live in your household? 0 1 2 3 4 5 6 7+ Question Title * 48. Do you or your family own the place where you are living now, or do you rent? Own Rent Question Title * 49. What is your ZIP code? ZIP code: Question Title * 50. How many years have you lived in Tompkins County? less than 1 1 - 2 years 3 - 4 years 5- 10 years 10+ years Done