Please enter the email you have with us.
Best Contact Phone Number *
What is the best number to contact you at via phone?
What year were you born *
Enter the year you were born, like 1999 or 1972.
Which best describes the gender to which you most identify?
-- SELECT BELOW -- Male Female Transgender Female Transgender Male Gender Variant or Non-Conforming Which County *
Which US County, Parish, or Township do you live in?
-- SELECT BELOW -- Alameda Alpine Amador Butte Calaveras Colusa Contra Costa Del Norte El Dorado Fresno Glenn Humboldt Imperial Inyo Kern Kings Lake Lassen Los Angeles Madera Marin Mariposa Mendocino Merced Modoc Mono Monterey Napa Nevada Orange Placer Plumas Riverside Sacramento San Benito San Bernardino San Diego San Francisco San Joaquin San Luis Obispo San Mateo Santa Barbara Santa Clara Santa Cruz Shasta Sierra Siskiyou Solano Sonoma Stanislaus Sutter Tehama Trinity Tulare Tuolumne Ventura Yolo Yaba Another County Not Listed|Other Zip Code
What zip code is your residence in?
90001 90002 90003 90008 90018 90037 90043 90044 90047 90056 90059 90061 90062 90220 90222 90247 90248 90249 90250 90301 90302 90303 90304 90305 90746 Another Zip Code Not Listed|Other Race/Ethnicity *
What is your race or ethnicity? If you are mixed race, select all races you represent.
Political Leaning *
Typically do you consider yourself more of a Democrat, Republican or something else? Even if you don't vote, how do you think about public policy?
-- SELECT BELOW -- Strong Democrat Independent leaning Democrat Independent Independent leaning Republican Strong Republican Liberal Moderate Conservative Education *
Which best describes the highest level of education you have had the opportunity to complete?
-- SELECT BELOW -- Some high school GED High school Some college (no certificate) Associates degree Technical school Bachelors degree Some post graduate Post graduate degree Focus Group Participation
In the last 12 months, have you participated in a focus group or telephone research study?
Do you work in, or have any training in any of the following industries or fields? Select all that apply.
Future School Attendence
In the next three years, would you consider attending any of the following schools whether it be for a certification or a degree? (select all that apply).
Children at home *
Do you have any children under the age of 18 at home?
Household Income *
Which category best represents your family's total household income, before taxes annually?
-- SELECT BELOW -- Under $20K $20-$35K $35-$50K $50-$80K $80-$100K $100-$150K $150-$250K $250K or more Employment Status *
Which best describes your current employment status?
-- SELECT BELOW -- Full-time Part-time Self-Employed Homemaker Retired Unemployed Student Disabled Payment Preference *
How would you like to receive your participation incentive? Digital payments are sent to the email address we have on file for you.
-- SELECT BELOW -- Amazon Cash App Check PayPal Venmo Zelle Address *
Please enter your mailing address so we can mail you your study information in addition to the email information you will receive from us.
Include your CITY, STATE, and ZIP CODE as well.
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