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2012
February
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Please indicate your gender.
Male
Female
How old are you?
Identify the group whose religious beliefs most closely resemble your own.
-- Select --
Catholic
Protestant
Wiccan
Hindu
Buddhist
Jewish
Muslim
Non-religious
Other
Rate the importance of your beliefs (or lack thereof) on your daily life. (1 - No importance; 10 - Strong importance)
Do you smoke cigarettes?
Yes
No
How many times per week do you use any illegal drugs, including (but not limited to) marijuana, cocaine or the unauthorized use of prescription drugs?
What is (or was) your Grade Point Average?
How many hours a week are you involved in volunteer or community service work?
Have you ever been convicted of a felony or served jail and/or prison time?
Is your or your family's income about the poverty line?
Yes
No
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