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What Is Your Housing Status?

RENTING

HOMEOWNER

HOMELESS / LIVING IN A SHELTER

LIVING WITH FAMILY / FRIEND

What Is Your Employment Status?

DISABILITY (SSDI)

FULL-TIME

PART-TIME

UNEMPLOYED

STUDENT

What Is Your Marital Status?

SINGLE - NEVER MARRIED

MARRIED OR DOMESTIC PARTNERSHIP

WIDOWED

DIVORCED

SEPARATED

What Is Your Education Level?

DID NOT GRADUATE HIGH SCHOOL

HIGH SCHOOL DIPLOMA / GED

SOME COLLEGE COMPLETED

GRADUATED COLLEGE

GRADUATE DEGREE OR ABOVE

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What Is Your Gender?

MALE FEMALE

What Is Your Date of Birth?

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