Background Information / Demographics
What is your marital status?
Married
Living in a marriage-like relationship
Widowed
Separated
Divorced
Never married
Not including yourself or your spouse/partner, how
many dependents (children or adults) do you have that is, how
many others receive at least one half of their financial support from you?
5 years of age or younger
6 to 18 years
19 years or older
Check if none:
| What is the highest educational attainment of your mother and father? Mark one for each parent. |
Mother |
Father |
| Less than high/secondary school graduate |
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| High/secondary school graduate |
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| Some college |
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| Bachelor's degree |
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| Master's degree (e.g., MA, MS, MBA, MSW, etc.) |
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| Professional degree (e.g., MD, DDS, JD, D.Min, Psy.D., etc.) |
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| Research doctoral degree |
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| Not applicable/Unknown |
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What is your place of birth?
State or territory (if U.S.)
OR Country (if not U.S.)
What is your date of birth?
What is your citizenship status?
U.S. CITIZEN Since birth
U.S. CITIZEN Naturalized
NON-U.S. CITIZEN With a Permanent U.S. Resident Visa ("Green Card")
NON-U.S. CITIZEN With a Temporary U.S. Visa
If you are a non-U.S. citizen, of which country are you a citizen?
Specify country of present citizenship
In what state or country was the high school/secondary school that you last
attended?
State or territory (if U.S.)
OR Country (if not U.S.)
Are you Hispanic or Latino?
No, I am not Hispanic or Latino
Yes, I am Mexican or Chicano
Yes, I am Puerto Rican
Yes, I am Cuban
Yes, I am Other Hispanic or Latino (please specify)
What is your racial background? (Please mark one or more.)
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