Web Sign Up Question Title * 1. Name OK Question Title * 2. Email: OK Question Title * 3. Address Street City, State Zip OK Question Title * 4. Home Phone: OK Question Title * 5. Cell Phone: OK Question Title * 6. Date of Birth MM/DD/YR OK Question Title * 7. Gender Male Female OK Question Title * 8. Employment Status Full-Time Part-Time Homemaker Retired Unemployed Student OK Question Title * 9. Ethnicity Caucasian African American Hispanic Native American Other Refused OK Question Title * 10. Education Some High School High School Grad Some College or Tech School College Grad Some Post Grad Post Graduate OK Question Title * 11. Marital Status Single Married Divorced Widowed Living with Partner OK Question Title * 12. Household Income Less than $35,000 $35,000 to $50,000 $50,000 to $74,000 $75,000 to $99,000 $100,000 to $124,000 $125,000 to $149,000 $150,000 to $174,000 $175,000 to $199,000 $200,000 to $300,000 $300,000+ OK Question Title * 13. Children in Household: Gender / Date of Birth (MM/DD/YR) Child 1 Child 2 Child 3 Child 4 Child 5 OK DONE