Exit this survey >> Question Title * What is your name? Question Title * What is the best phone number for us to contact you on? Question Title * What is your gender? Female Male Question Title * What is your age? Question Title * Which of the following choices best describes your ethnicity? African American Asian Caucasian Hispanic/Latino Native American Other Question Title * What City and State do you currently reside in? Question Title * Which of the following best describes your marital status? Single Married or living with partner Divorced, Separated, Widowed Question Title * Do you have any children under 18 years old? Yes No Question Title * Which of the following best describes your current employment situation? Employed full-time Employed part-time Self-employed Student Homemaker Retired Not employed Question Title * What is the highest level of education you have had the opportunity to complete? Some High School or Less High School Some College Trade/Technical School College Graduate Some Post-Graduate Work Advanced Degree Question Title * Into which of the following ranges does you annual household income fall? $34K & under $35K to $39K $40K to $49K $50K to $59K $60K to $69K $70K to $79K $80K to $89K $90K to $99K $100K or more Question Title * What industry do you work in? Next >>