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  2. 2012
  3. July
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  5. Preliminary Questionnaire
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How many siblings do you have?
 
0
 
1
 
2
 
3 or more
 
 
 
What is your marital status?
 
Single
 
Married
 
Divorced
 
Widow
 
 
 
Do you wear glasses or contact lenses?
 
Yes
 
No
 
 
 
What is your religious affiliation?
 
Agnostic
 
Atheist
 
Catholic
 
Hindu
 
Jewish
 
Muslim
 
Protestant
 
Other
 
 
 
Have you ever studied a foreign language(s)? If so, please list them here:
   
 
 
 
What regions of the world did your ancestors/family live in before coming to the United States?
 
Eastern Europe
 
Western Europe
 
Middle East
 
Northern Africa
 
Sub-Saharan Africa
 
Southeast Asia
 
East Asia
 
Central America
 
South America
 
Pacific Islands

 
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