Household Research Question Title * 1. Contact info: (Required.) First and last name City/Town State/Province Email Address Phone Number Question Title * 2. What is your gender? (Required.) Male Female Other (please specify) Question Title * 3. What is your age? (Required.) Question Title * 4. For classification purposes, are you currently: (Required.) Employed full time Employed part time Homemaker Unemployed Student Currently unemployed Retired Question Title * 5. Who else currently lives in your home? (Required.) Child(ren) under 18 Roommate(s) Spouse/partner Child(ren) over 18 Someone else(please specify) Next
