International Advisory Panel

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International Advisory Panel

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Please be assured that your responses are strictly confidential and that no information about you will be revealed to anyone. The information you provide will only be used in calculating statistics about the panel as a whole.


Background QuestionsAlien Background

      Please answer all questions:

      1. Your sex:

      		Male
      Female
      2. Your age:
      12 or less
      13 to 19
      20 to 29
      30 to 39
      40 to 49
      50 or more
      3. Where do you live?
      Your city:  
      Your state or province:  
      Your country:  
      4. Are you married?
      Yes
      No
      5. Do you have any children living at home? (Check all that apply)
      None
      Aged 12 or less
      Aged 13 to 19
      Over 19
      6. How much education have you completed?
      Elementary School
      High School
      College
      Graduate or Professional School
      7. Your employment status:
      Employed full-time
      Employed part-time
      Student
      Homemaker
      Retired
      Other:

      8. What is your occupation or profession? (Examples: engineer, homemaker, farmer, clerk, student, etc.)  

      9. In what industry do you work? (Even if you are not currently employed).  (Examples: computers, agriculture, health care, education, etc.)  
      10. Your total household income for one year:
      Under $25,000
      $25,000 to $50,000
      $50,000 to $75,000
      Over $75,000
      11. Your ethnic heritage
      African-American
      Asian
      Hispanic or Latino
      Caucasian
      Other
      12. How did you learn about us? 
      13. Your first name: 
      14. Your last name: 
      15. Your email address (for notifying you about new surveys):   
       

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