Scenerio ID
*
First Name
*
Last Name
*
User ID
*
User Password
*
Organization
Role in Organization
Street Address
City
State
Zip Code
Phone Number
Email Address
*
Gender
Male
Female
Marital Status
Married
Divorced or Separated
Widowed
Single never married
Age Status
14-17
18-24
25-34
35-44
45-54
55-64
65+
Highest Level of Formal Education Completed
Grade 8 or less
Graduated High School
1-3 years of College
Graduated College (4 years)
Attended or Completed Grad School
Current Occupation
Professional/Managerial
Retired
Clerical or Service Worker
Homemaker
Factory Worker/Laborer/Driver
Unemployed
Salesperson
College Student
Military
Annual Household Income
Less than $15,000
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 or more
Number of Persons in Household
1
2
3
4
5+
Number of Children in Household
0
1
2
3
4+