Exit this survey >> Question Title * 1. What is your name? Question Title * 2. What is the best phone number for us to reach you on? Question Title * 3. Email Address: Question Title * 4. What is your gender? Male Female Question Title * 5. What is your age? Question Title * 6. Which of the following best describes your ethnic background? African American Asian Caucasian Hispanic/Latino Native American Other Question Title * 7. And which of the following best describes your marital status: Single Married Living with significant other Question Title * 8. Which of the following best describes your employment situation? Employed full-time Employed part-time Self-employed Homemaker Student Retired Not employed Question Title * 9. 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 College Advanced Degree Question Title * 10. Can you please tell me what your total household income was last year? Under $50,000 $50,000 - $75,000 $75,000 - $99,999 $100,000 - $124,999 $125,000 - $149,999 $150,000 - $199,999 $200,000 or more Question Title * 11. What industry do you work in? Question Title * 12. What is your occupation/profession? Next >>