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Exit Survey
 
 
What is your age?
 
Under 18
 
18-24
 
25-34
 
35-44
 
45-54
 
55-64
 
65-74
 
75-84
 
85 or older
 
 
 
Choose one or more of the races you consider yourself to be:
 
White
 
Asian
 
Black or African American
 
American Indian or Alaska Native
 
Native Hawaiian or Pacific Islander
 
Other
 
 
 
 
What is your sex?
 
Male
 
Female
 
 
 
Which province or territory of Canada do you live in?
 
Ontario
 
Quebec
 
Nova Scotia
 
New Brunswick
 
Manitoba
 
British Columbia
 
Prince Edward Island
 
Saskatchewan
 
Alberta
 
Newfoundland and Labrador
 
Northwest Territories
 
Yukon
 
Nunavut
 
 
 
Please indicate the answer that includes your entire household income in (previous year) before taxes.
 
Less than $10,000
 
$10,000 to $19,999
 
$20,000 to $29,999
 
$30,000 to $39,999
 
$40,000 to $49,999
 
$50,000 to $59,999
 
$60,000 to $69,999
 
$70,000 to $79,999
 
$80,000 to $89,999
 
$90,000 to $99,999
 
$100,000 to $149,999
 
$150,000 or more
 
 
 
Which statement best describes your current employment status?
 
Working (paid employee)
 
Working (self-employed)
 
Not working (temporary layoff from a job)  
 
Not working (looking for work)
 
Not working (retired)
 
Not working (disabled)
 
Not working (other)
 
 
 
 
Where are you employed?
 
PRIVATE-FOR-PROFIT company, business or individual, for wages, salary or commissions
 
PRIVATE-NOT-FOR-PROFIT, tax-exempt, or charitable organization
 
Local GOVERNMENT employee (city, county, etc.)
 
State GOVERNMENT employee; 5-Federal GOVERNMENT employee
 
Federal GOVERNMENT employee
 
SELF-EMPLOYED in own NOT INCORPORATED business, professional practice, or farm
 
SELF-EMPLOYED in own INCORPORATED business, professional practice, or farm
 
Working WITHOUT PAY in family business or farm
 
 
 
Please indicate your occupation:
 
Management, professional, and related
 
Service
 
Sales and office
 
Farming, fishing, and forestry
 
Construction, extraction and maintenance 
 
Production, transportation, and material moving
 
Government
 
Retired
 
Unemployed
 
 
 
Are you a parent?
 
Yes
 
No
 
 
 
What is the age of your child?