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What is your gender?
How old are you?
What is your current occupation? (U.S. Census 17 Categories)
In which industry are you employed? (U.S. Census Categories)
Are you a member of any type of professional organization or union?
Please check all that appy.
What is your current status?
5. How many children (under the age of 18) are currently living in your house?
What is the highest level of education you have completed?
What type of car do you drive?
How well does each of the following statements describes you?
How well does each of the following statements describes you?
 
   
   
   
   
   
   
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