* 1. Are you male or female?

* 2. Which category below includes your age?

* 3. Is English your primary language?

* 4. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian, Pacific Islander, or some other race?

* 5. Do you receive transportation services from other government, non-profit, or private agencies?

* 6. Do any of the following apply to your current situation?

* 7. What is your current living arrangement?

* 8. Which of the following categories best describes your employment status?

* 9. What is the highest level of school you have completed or the highest degree you have received?

* 10. How much total combined money did all members of your HOUSEHOLD earn in 2015? This includes money from jobs; net income from business, farm, or rent; pensions; dividends; interest; social security payments; and any other money income received by members of your HOUSEHOLD that are EIGHTEEN (18) years of age or older. Please report the total amount of money earned - do not subtract the amount you paid in taxes or any deductions listed on your tax return.

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