Email *
What is your gender? * Gender Male Female Other
Which category below includes your age? * Age 18-20 21-29 30-39 40-49 50-59 60 or older
Are you now married, widowed, divorced, separated, or never married? * Status Married Widowed Divorced Separated Never married
What is the highest level of school you have completed or the highest degree you have received? * Education Less than high school degree High school degree or equivalent (e.g., GED) Some college but no degree Associate degree Bachelor degree Graduate degree
Which of the following categories best describes your employment status? * Employment Status Employed, working 1-39 hours per week Employed, working 40 or more hours per week Not employed, looking for work Not employed, NOT looking for work Retired Disabled, not able to work
How much total combined money did all members of your household earn last year? * Household Income $0 – $9,999 $10,000 – $19,999 $20,000 – $29,999 $30,000 – $39,999 $40,000 – $49,999 $50,000 – $59,999 $60,000 – $69,999 $70,000 – $79,999 $80,000 – $89,999 $90,000 – $99,999 $100,000 or more
Which of the following best describes your current occupation? * Choose Occupation Agriculture, Food and Natural Resources Architecture and Construction Education and Training Business Management and Administration Arts, Audio/Video Technology and Communications Finance Government and Public Administration Health Science Hospitality and Tourism Human Services Information Technology Law, Public Safety, Corrections and Security Manufacturing Market Research Marketing, Sales and Service Science, Technology, Engineering and Mathematics Transportation, Distribution and Logistics
Provinces and territories Choose Provinces and Territories Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
State Choose State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky[D] Louisiana Maine Maryland Massachusetts[D] Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania[D] Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia[D] Washington West Virginia Wisconsin Wyoming District of Columbia