Name * First Name Last Name Email * Current Zip Code * Gender Male Female Age Group 18-29 30-39 40-49 50-59 60-69 70+ How would you describe yourself? African-American/Black Asian Hispanic/Latino Native Hawaiian/Other Pacific Islander Two or more races White Prefer not to answer My approximate household income is: Less than $25,000 $25,000 to $49,999 $50,000 to $99,999 $100,000 to $199,999 $200,000 or more Prefer not to answer Thank you!
