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What is your age?
Under 18
18 to 24
25 to 34
35 to 44
45 to 60
61+
How would you describe your gender?
Male
Female
Other Gender
Prefer not to say
What is your ethnicity?
White/Caucasian
East Asian
South Asian
Hispanic
African American
Native American
Other
Prefer not to say
In what region of the US do you live in?
West
Northwest
Southwest
Northeast/New England
Mid-Atlantic
Southeast
Midwest
What is your employment status?
Full-time
Part-time
Contract/Temporary
Unemployed
Unable to work
Student
Other
Prefer not to say
Including yourself, how many people live in your household?
1
2
3
4
5+
What is the level of your annual household income?
Less than 25k
$25k to $50k
$50k to $100k
$100k to $200k
More than $200k
Prefer not to say
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