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Household Information IF recruitment type = 6 THEN | | IF consent form 1 = EMPTY THEN || | | consent1 consent form 1 | | By clicking NEXT below, I certify that I am [name on button] and as of today, am 18 years or older. | | 1 I understand my participation in the RAND American Life Panel is voluntary and that I can stop participating | | at any time | | 2 That is not my name, but I still wish to participate | | 3 I am not 18 years or older || | | IF consent form 1 = 2 THEN ||| | | | consent2 consent form 2 | | | Please enter your name and contact info in this box and we will contact you with correct login information. | | | Memo ||| | | ENDIF || | ENDIF | ENDIF IF (recruitment type = 6 and consent1=1) then) OR recruitment type <> 6 THEN | | IN001 INTRODUCTION | Our goal is to improve policymaking by informing decision makers about how the public is | responding to policy changes and life changes. You are part of a randomly selected sample, | especially chosen to represent the U.S. both geographically and demographically. To make sure that | this selection process is working properly, we would like you to complete this short questionnaire | about your household, your background, and your work.By keeping this information current, we will | be able to compare our panel to U.S. Census data. This will ensure that our results accurately | reflect what is happening across the nation. We will also be able to assess how different types of | households are affected by policy changes and life changes. In the future when you login, we will | ask you to update us about any important changes to your household or your work as described in | this questionnaire. | | gender GENDER | What is your gender? | 1 Male | 2 Female | | [Questions IN002 to birthyear are displayed as a table] | | IN002 BIRTH DATE HEADER | What is your birth date? | | birthyear BIRTH YEAR | Year | 11 1911 | 12 1912 | 13 1913 | 14 1914 | 15 1915 | 16 1916 | 17 1917 | 18 1918 | 19 1919 | 20 1920 | 21 1921 | 22 1922 | 23 1923 | 24 1924 | 25 1925 | 26 1926 | 27 1927 | 28 1928 | 29 1929 | 30 1930 | 31 1931 | 32 1932 | 33 1933 | 34 1934 | 35 1935 | 36 1936 | 37 1937 | 38 1938 | 39 1939 | 40 1940 | 41 1941 | 42 1942 | 43 1943 | 44 1944 | 45 1945 | 46 1946 | 47 1947 | 48 1948 | 49 1949 | 50 1950 | 51 1951 | 52 1952 | 53 1953 | 54 1954 | 55 1955 | 56 1956 | 57 1957 | 58 1958 | 59 1959 | 60 1960 | 61 1961 | 62 1962 | 63 1963 | 64 1964 | 65 1965 | 66 1966 | 67 1967 | 68 1968 | 69 1969 | 70 1970 | 71 1971 | 72 1972 | 73 1973 | 74 1974 | 75 1975 | 76 1976 | 77 1977 | 78 1978 | 79 1979 | 80 1980 | 81 1981 | 82 1982 | 83 1983 | 84 1984 | 85 1985 | 86 1986 | 87 1987 | 88 1988 | 89 1989 | 90 1990 | 91 1991 | 92 1992 | 93 1993 | 94 1994 | 95 1995 | 96 1996 | 97 1997 | 98 1998 | 99 1999 | | IF CALCULATED AGE > 100 THEN || | | checkOver100 check age over 100 | | Just to confirm, you are currently [CALCULATED AGE] years old? If not, please go back and fix | | your birth date. If so, congratulations, and click next! || | ENDIF | | | borninus BORN IN US | Were you born in the United States? | 1 Yes | 2 No | | IF BORN IN US = Yes THEN || | | stateborn STATE BORN | | In what state were you born? | | 1 ALASKA (AK) | | 2 ALABAMA (AL) | | 3 ARIZONA (AZ) | | 4 ARKANSAS (AR) | | 5 CALIFORNIA (CA) | | 6 COLORADO (CO) | | 7 CONNECTICUT (CT) | | 8 DELAWARE (DE) | | 9 FLORIDA (FL) | | 10 GEORGIA (GA) | | 11 HAWAII (HI) | | 12 IDAHO (ID) | | 13 ILLINOIS (IL) | | 14 INDIANA (IN) | | 15 IOWA (IA) | | 16 KANSAS (KS) | | 17 KENTUCKY (KY) | | 18 LOUISIANA (LA) | | 19 MAINE (ME) | | 20 MARYLAND (MD) | | 21 MASSACHUSETTS (MA) | | 22 MICHIGAN (MI) | | 23 MINNESOTA (MN) | | 24 MISSISSIPPI (MS) | | 25 MISSOURI (MO) | | 26 MONTANA (MT) | | 27 NEBRASKA (NE) | | 28 NEVADA (NV) | | 29 NEW HAMPSHIRE (NH) | | 30 NEW JERSEY (NJ) | | 31 NEW MEXICO (NM) | | 32 NEW YORK (NY) | | 33 NORTH CAROLINA (NC) | | 34 NORTH DAKOTA (ND) | | 35 OHIO (OH) | | 36 OKLAHOMA (OK) | | 37 OREGON (OR) | | 38 PENNSYLVANIA (PA) | | 39 RHODE ISLAND (RI) | | 40 SOUTH CAROLINA (SC) | | 41 SOUTH DAKOTA (SD) | | 42 TENNESSEE (TN) | | 43 TEXAS (TX) | | 44 UTAH (UT) | | 45 VERMONT (VT) | | 46 VIRGINIA (VA) | | 47 WASHINGTON (WA) | | 48 WEST VIRGINIA (WV) | | 49 WISCONSIN (WI) | | 50 WYOMING (WY) | | 51 WASHINGTON D.C. | | 52 PUERTO RICO || | ENDIF || | currentlivingsituation CURRENT LIVING SITUATION | Could you tell us what your current living situation is? | 1 Married or living with a partner | 2 Separated | 3 Divorced | 4 Widowed | 5 Never married | | highesteducation HIGHEST EDUCATION | What is the highest level of school you have completed or the highest degree you have received? | 1 Less than 1st grade | 2 1st,2nd,3rd,or 4th grade | 3 5th or 6th grade | 4 7th or 8th grade | 5 9th grade | 6 10th grade | 7 11th grade | 8 12th grade NO DIPLOMA | 9 HIGH SCHOOL GRADUATE high school DIPLOMA or the equivalent (For example: GED) | 10 Some college but no degree | 11 Associate degree in college Occupational/vocational program | 12 Associate degree in college Academic program | 13 Bachelor's degree (For example: BA,AB,BS) | 14 Master's degree (For example: MA,MS,MEng,MEd,MSW,MBA) | 15 Professional School Degree (For example: MD,DDS,DVM,LLB,JD) | 16 Doctorate degree (For example: PhD,EdD) | | hispaniclatino HISPANIC LATINO | Do you consider yourself Hispanic or Latino? | 1 Yes | 2 No | | white WHITE | Do you consider yourself primarily white or Caucasian, Black or African American, American Indian, or Asian? | 1 White/Caucasian | 2 Black/African American | 3 American Indian or Alaskan Native | 4 Asian or Pacific Islander | 5 Other || | currentjobstatus CURRENT JOB STATUS | What is your current employment situation? | 1 Working Now | 2 Unemployed and looking for work | 3 Temporarily laid off, on sick or other leave | 4 Disabled | 5 Retired | 6 Homemaker | 7 Other | | IF Other IN CURRENT JOB STATUS THEN || | | currentjobstatusother CURRENT JOB STATUS OTHER | | Please specify. | | String || | ENDIF | | IF Working Now IN CURRENT JOB STATUS THEN || | | doyouwork DO YOU WORK | | Next are some questions about your current, main job. Do you work for someone else, are you | | self-employed, or what? | | 1 Work for someone else | | 2 Self-employed | | 3 Other || | | typework TYPE WORK | | Which of the following categories best describes the type of work you [DO/DID]? | | 1 Management Occupations | | 2 Business and Financial Operations Occupations | | 3 Computer and Mathematical Occupations | | 4 Architecture and Engineering Occupations | | 5 Life, Physical, and Social Science Occupations | | 6 Community and Social Services Occupations | | 7 Legal Occupations | | 8 Education, Training, and Library Occupations | | 9 Arts, Design, Entertainment, Sports, and Media Occupations | | 10 Healthcare Practitioner and Technical Occupations | | 11 Healthcare Support Occupations | | 12 Protective Service Occupations | | 13 Food Preparation and Serving Related Occupations | | 14 Building and Grounds Cleaning and Maintenance Occupations | | 15 Personal Care and Service Occupations | | 16 Sales and Related Occupations | | 17 Office and Administrative Support Occupations | | 18 Farming, Fishing, and Forestry Occupations | | 19 Construction and Extraction Occupations | | 20 Installation, Maintenance, and Repair Occupations | | 21 Production Occupations | | 22 Transportation and Material Moving Occupations || | ELSE || | | IF Unemployed and looking for work IN CURRENT JOB STATUS OR Temporarily laid off, on sick or | | other leave IN CURRENT JOB STATUS OR Disabled IN CURRENT JOB STATUS OR Retired IN CURRENT JOB | | STATUS THEN ||| | | | typework TYPE WORK | | | Which of the following categories best describes the type of work you [DO/DID]? | | | 1 Management Occupations | | | 2 Business and Financial Operations Occupations | | | 3 Computer and Mathematical Occupations | | | 4 Architecture and Engineering Occupations | | | 5 Life, Physical, and Social Science Occupations | | | 6 Community and Social Services Occupations | | | 7 Legal Occupations | | | 8 Education, Training, and Library Occupations | | | 9 Arts, Design, Entertainment, Sports, and Media Occupations | | | 10 Healthcare Practitioner and Technical Occupations | | | 11 Healthcare Support Occupations | | | 12 Protective Service Occupations | | | 13 Food Preparation and Serving Related Occupations | | | 14 Building and Grounds Cleaning and Maintenance Occupations | | | 15 Personal Care and Service Occupations | | | 16 Sales and Related Occupations | | | 17 Office and Administrative Support Occupations | | | 18 Farming, Fishing, and Forestry Occupations | | | 19 Construction and Extraction Occupations | | | 20 Installation, Maintenance, and Repair Occupations | | | 21 Production Occupations | | | 22 Transportation and Material Moving Occupations ||| | | ENDIF || | ENDIF | | householdmembers HOUSEHOLD MEMBERS | Now we would like to know about other members of your household, if there are any. [/PREVIOUSLY | YOU INDICATED THAT YOU LIVE WITH YOUR] How many other people live with you [/OTHER THAN YOUR | SPOUSE OR PARTNER]? (enter 0 for no one else). | Range: 0..10 | | | familyincome FAMILY INCOME | Which category represents the total combined income of all members of your family (living here) | during the past 12 months? This includes money from jobs, net income from business, farm or rent, | pensions, dividends, interest, social security payments and any other money income received by | members of your family who are 15 years of age or older. | 1 Less than $5,000 | 2 $5,000 to $7,499 | 3 $7,500 to $9,999 | 4 $10,000 to $12,499 | 5 $12,500 to $14,999 | 6 $15,000 to $19,999 | 7 $20,000 to $24,999 | 8 $25,000 to $29,999 | 9 $30,000 to $34,999 | 10 $35,000 to $39,999 | 11 $40,000 to $49,999 | 12 $50,000 to $59,999 | 13 $60,000 to $74,999 | 14 $75,000 or more | | IF FAMILY INCOME = $75,000 or more THEN || | | familyincome_part2 FAMILY INCOME PART 2 | | You told us that the total combined income of all members of your family (living here) during | | the preceding 12 months was more than $75,000. Thinking about the total combined income of your | | family from all sources, approximately how much did members of your family receive during the | | previous 12 months? | | 1 $75,000-$99,999 | | 2 $100,000-$124,999 | | 3 $125,000-$199,999 | | 4 $200,000 or more || | ENDIF | | internetlocation INTERNET LOCATION | Finally, we would like to know how you are communicating with us. From what location are you | currently connected to the Internet? | 1 Home | 2 Work | 3 Internet cafe, library, etc. | 4 Elsewhere | | IF INTERNET LOCATION = Elsewhere THEN || | | internetlocationother INTERNET LOCATION OTHER | | Please specify. | | String || | ENDIF | | internettypeconnection INTERNET TYPE CONNECTION | What type of internet connection do you have at that location? | 1 Dial-up modem (via personal computer or internet player) | 2 Cable modem | 3 DSL | 4 Satellite dish | 5 Local network | 6 Other connection | 7 Don't know | | IF INTERNET TYPE CONNECTION = Dial-up modem (via personal computer or internet player) THEN || | | typemodem TYPE MODEM | | What type of modem do you use to connect to the internet? | | 1 14.4k modem | | 2 28.8k modem | | 3 33.6k modem | | 4 56k modem | | 5 Don't know || | ENDIF | ENDIF
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