Interviewer Expression of Interest Question Title * 1. Please enter your full name Question Title * 2. Please enter your preferred email address Question Title * 3. Does interviewing seniors work interest you? Extremely interested Very interested Somewhat interested Not so interested Not at all interested Question Title * 4. How many hours a week would you want to interview seniors? Question Title * 5. Are there times of the year when you would want to work more? Question Title * 6. Are there times of the year when you would want to work less? Question Title * 7. Rate your skills for eliciting specific data from open ended questions 1 poor 10 excellent Clear i We adjusted the number you entered based on the slider’s scale. Question Title * 8. Do you own a computer? Yes No Question Title * 9. What state do you reside in? Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia (DC) Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Question Title * 10. What language do you speak fluently? Arabic Armenian Chinese English French French Creole German Greek Gujarati Hindi Italian Japanese Korean Persian Polish Portuguese Russian Spanish Tagalog Urdu Vietnamese Other (please specify) Done
