GNB's Demographic Survey Question Title * 1. What is your approximate average household income? Include total income of all adults in your household. $0-$24,999 $25,000-$49,999 $50,000-$74,999 $75,000-$99,999 $100,000-$124,999 $125,000-$149,999 $150,000 and above Question Title * 2. How many children age 17 or younger live in your household? None 1 2 3 4 Other (please specify) Question Title * 3. Including yourself, how many people currently live in your household? 1 2 3 4 Other (please specify) Question Title * 4. How many adults in your household? 1 2 3 4 Other (please specify) Question Title * 5. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305) 34471 34472 34474 34475 Other (please specify) Question Title * 6. What is the current work status of adults in your household? Check all that apply to your household. Employed Full-time Employed Part-time Self Employed Student (College) Retired Unemployed Question Title * 7. Approximate age of all adults within the household? Check all that apply. 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 Other (please specify) Question Title * 8. Approximate age of all children within your household? Check all that apply. 0 - 4 5 - 9 10 -13 14 - 17 Question Title * 9. Which of the following best describes your current relationship status? Married Widowed Divorced Separated Single, but cohabiting with a significant other Single, never married Question Title * 10. Which of the following best describes your household? Single Married (no children) Single Parent Home Married with children Grandparent(s) raising grandchild(ren) Relative raising children of family member Done