$125 Online Opinion Study Online / Offline Activities Question Title * 1. Contact Info Name Phone E-Mail Gender Age State Question Title * 2. Are you of Hispanic, Latino, or Spanish origin? No Yes – Mexican, Mexican American, Chicano Yes – Puerto Rican Yes – Cuban Yes – other Hispanic, Latino, or Spanish origin Question Title * 3. Which of these best describes your racial background? Please select all that apply. White Black or African American American Indian or Alaskan Native Asian Native Hawaiian or other Pacific Islander Other (please specify) Question Title * 4. What is your annual household income (before tax)? My household does not have an income Under $15,000 $15,000 to $24,999 $25,000 to $34,999 $35,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 $100,000 to $149,999 $150,000 to $199,999 $200,000 and over Question Title * 5. Which of the following best describes the area you live in? Urban Suburban Rural Question Title * 6. How many people (including you) live in your household? 1 – only me 2 3 4 5 or more people Question Title * 7. How many children (aged under 18) are there living in your household?NOT REQUIRED **** 0 – no children 1 2 3 4 5 or more children Next