Exit this survey >> Question Title * What is your FIRST and LAST name? Question Title * What is the best phone number for us to contact you on? Question Title * What is your gender? Male Female Question Title * What is your age? Question Title * What City and State do you currently reside in? Question Title * Which of the following best describes your ethnic background? African American Asian Caucasian Hispanic/Latino Native American Other 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 17 or younger living in your household? Yes No Question Title * Which of the following best describes your employment situation? Employed full-time Employed part-time Self-employed Homemaker Student 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/GED Some College Trade/Technical School College Graduate Some Post College Advanced Degree Question Title * What industry do you work in? Next >>