Number of persons living in your household:

Me
My spouse
My partner
My roommates
My parent (s)
My step-parent (s)
My own children
My step-children
My brothers
My sisters
My step-brothers
My step-sisters
Foster children
Other relatives
Others

To be answered by parents only:

How many children (all ages) do you have?
How many of your children (17 or under) live with you?
How many of your children (17 or under) live with another parent?
How many of your children (17 or under) live with neither parent? (grandparents, other relatives, non-relatives, foster home)
To be answered if you are 17 or under only:
How many brothers and sisters (all ages) do you have?
How many of your brothers and sisters (17 or under) live with you?
How many of your brothers and sisters (17 or under) live another parent?
How many of your brothers and sisters (17 or under) live with neither parent? (grandparents, other relatives, non-relatives, foster home)

About your beliefs...
Religious Beliefs	Agnostic Atheist Christian Jewish Muslim Buddhist Hindu Taoist Unitarian Universalist Spiritualist Secular Other
How often do you attend services in your house of worship?	Daily Weekly Monthly Yearly Seldom or never
Country of Birth	United States Northern America Latin America and the Carribean Europe Africa Asia Oceania
Which of the following categories best describes you?	African American Hispanic or Latino White/Caucasian Asian American Native American South Asian/Indian Subcontinent Multi-racial Other
Household Income:	$100,000 or more Between 75 and 100 thousand Between 50 and 75 thousand Between 40 and 50 thousand Between 30 and 40 thousand Between 20 and 30 thousand Between 10 and 20 thousand Less than $10,000
Education Level:	Less than high school Some high school High school diploma or equivalent Some collegeFour-year college diploma Some graduate or professional schoolGraduate or professional degree
Sexual Orientation	Straight/Heterosexual Gay male Lesbian Bisexual Other

About your views...

Please read the following statements, and then indicate whether you agree or disagree.

1. Big corporations have too much influence and organized labor has too little influence in shaping governmental policies.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

2. Colleges should not try to promote racial diversity by applying different standards of admission for white and African-American applicants.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

3. Illegal immigrants should eventually be allowed to become citizens if they are Law-abiding, learn English, and pay taxes.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

4. Women in two-earner families who can manage without a second income should stay home and care for their children.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

5. Drug addiction is a public health problem and should not be considered a crime.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

6. Prayer and other religious observances should be included as part of the program of public schools

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

7. Women should be permitted to choose whether or not to have an abortion.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

8. The President, as Commander-in-Chief, should do whatever he thinks is required to combat terrorism without interference by Congress and the courts.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

9. Same-sex couples should have the right to marry.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

10. There should be a law or a constitutional amendment which makes it illegal to burn or mutilate our flag.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

11. The United States should adopt a tax-supported system of health insurance which covers all Americans.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

12. The American people supported the decision to invade Iraq because they were misled by their leaders.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

13. The government should support efforts to cure serious diseases by funding stem cell research on human embryos.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

14. Nowadays parents are too inclined to pamper their children instead of emphasizing discipline, work and duty.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

15. Defendants who are convicted of first-degree murder at a fair trial should be given the death penalty.

Strongly agree

Mostly agree

Don't know or No opinion

Mostly disagree

Strongly disagree

About your job...

Your Employment Situation

Full-time employee Part-time employee (25 hours or less) Self-employed, Full time Self-employed, Part time (25 hours or less) Unemployed, looking for a job Unemployed, independent income Unemployed, retired Unemployed, disabled Full-time homemaker, work not compensated by wages

If you are unemployed or a full-time homemaker we have no further questions and we are grateful for your cooperation in advancing our work.

For Employed Persons:

Do you have more than one job?

Yes No

  If you have more than one job, please answer the following questions for your main job, the one at which you work the most hours in a typical week.

In a typical week, how many hours do you work at your main job?	10 20 30 40 50 60 or more
What are your usual annual earnings at your main job including overtime pay, tips and commissions and before taxes or other deductions?	$100,000 or more Between 75 and 100 thousand Between 50 and 75 thousand Between 40 and 50 thousand Between 30 and 40 thousand Between 20 and 30 thousand Between 10 and 20 thousand Less than $10,000
Does your employer offer a health insurance plan for you?	Yes No
Does your employer offer a pension or retirement plan for you?	Yes No
How easy would it be for you to find another job that is at least as attractive as your main job?	Very difficult Difficult Easy Very easy
Overall, how satisfied are you with your present job? Are you	Very satisfied Satisfied Not very satisfied Not at all satisfied

How closely do the following statements describe your situation at work? Please select your answer from the choices below each statement.

1. My work is physically demanding and requires muscle.

Definitely not

Mostly not

Mostly yes

Definitely yes

2. People in my position are at risk of being fired or laid off.

Definitely not

Mostly not

Mostly yes

Definitely yes

3. My work requires constant attention to avoid mistakes.

Definitely not

Mostly not

Mostly yes

Definitely yes

4. I can plan my own activities.

Definitely not

Mostly not

Mostly yes

Definitely yes

5. There are many opportunities to show initiative.

Definitely not

Mostly not

Mostly yes

Definitely yes

6. Giving advice to other workers is part of my job.

Definitely not

Mostly not

Mostly yes

Definitely yes

7. I supervise others.

Definitely not

Mostly not

Mostly yes

Definitely yes

8. I can chat with other workers.

Definitely not

Mostly not

Mostly yes

Definitely yes

 

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