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Questions marked with a * are required Exit Survey
 
 
What is your gender?
 
Male
 
Female
 
Other
 
Prefer not to specify

 
 
 
What is your age?
 
18 to 24
 
25 to 34
 
35 to 44
 
45 to 54
 
55 to 64
 
65 to 74
 
75 or older
 
 
 
What is the highest level of school that you have completed?
 
Primary school
 
Some high school, but no diploma
 
High school diploma (or GED)
 
Some college, but no degree
 
2-year college degree
 
4-year college degree
 
Graduate-level degree
 
None of the above
 
 
 
What is your approximate average household income?
 
$0-$24,999
 
$25,000-$49,999
 
$50,000-$74,999
 
$75,000-$99,999
 
$100,000-$124,999
 
$125,000-$149,999
 
$150,000-$174,999
 
$175,000-$199,999
 
$200,000 and up

 
 
 
Which of the following best describes your current occupation?
 
Legal Occupations
 
Business and Financial Operations Occupations
 
Life, Physical, and Social Science Occupations
 
Healthcare Support Occupations
 
Personal Care and Service Occupations
 
Arts, Design, Entertainment, Sports, and Media Occupations
 
Office and Administrative Support Occupations
 
Construction and Extraction Occupations
 
Healthcare Practitioners and Technical Occupations
 
Architecture and Engineering Occupations
 
Building and Grounds Cleaning and Maintenance Occupations
 
Farming, Fishing, and Forestry Occupations
 
Production Occupations
 
Management Occupations
 
Protective Service Occupations
 
Food Preparation and Serving Related Occupations
 
Computer and Mathematical Occupations
 
Community and Social Service Occupations
 
Sales and Related Occupations
 
Installation, Maintenance, and Repair Occupations
 
Education, Training, and Library Occupations
 
Transportation and Materials Moving Occupations
 
Other (please specify)

 
 
 
* In what city do you live?
   
 
 
 
* What do you do in your free time?
   
 
 
 
How many times a week do you eat out?
 
Once
 
Twice
 
3 times
 
4 times
 
5+

 
 
 
About how often do you eat fast food?
 
Every day
 
A few times a week
 
A few times a month
 
Less than a few times a month
 
Never

 
 
 
In what type of community do you live?
 
City or urban community
 
Suburban community
 
Rural community
 
Other (please specify)