1. Tell us about You

* 1. What is your gender?

* 2. What is your age?

* 3. Your household consists of:

* 4. What are the ages of your children? (You can choose more than one answer)

* 5. How many years have you lived in your present home?

* 6. What language do you mainly speak at home?

* 7. Do any occupants of your house hold have a disability or chronic illness?

Page1 / 5
 
20% of survey complete.

T