going to ask you some general questions. Let’s begin!” “I’m Head of Household Person 2 Person 3 Person 4 Person 5 What are your… Initials? Date of Birth? Age? Head of Household Person 2 Person 3 Person 4 Person 5 How are persons Head of Household Child Child Child ⃝ ⃝ ⃝ ⃝ ⃝ 2 through 5 Spouse or Partner Spouse or Partner Spouse or Partner Spouse or Partner ⃝ ⃝ ⃝ ⃝ related to you? Family Member Other Family Member Family Member Family Member ⃝ ⃝ ⃝ ⃝ [This question is only for Other, non-related Other, non-related Other, non-related Other, non-related ⃝ ⃝ ⃝ ⃝ the Head of Household] Head of Household Person 2 Person 3 Person 4 Person 5 What is your American Indian or American Indian or American Indian or American Indian or American Indian or ⃝ ⃝ ⃝ ⃝ ⃝ primary race? Alaskan Native Alaskan Native Alaskan Native Alaskan Native Alaskan Native [Please select one] Asian Asian Asian Asian Asian ⃝ ⃝ ⃝ ⃝ ⃝ Black or African Black or African Black or African Black or African Black or African ⃝ ⃝ ⃝ ⃝ ⃝ American American American American American Native Hawaiian or Native Hawaiian or Native Hawaiian or Native Hawaiian or Native Hawaiian or ⃝ ⃝ ⃝ ⃝ ⃝ Other Pacific Islander Other Pacific Islander Other Pacific Islander Other Pacific Islander Other Pacific Islander White White White White White ⃝ ⃝ ⃝ ⃝ ⃝ Know Doesn’t Know Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Other: Other: Other: Other: ⃝ ⃝ ⃝ ⃝ ⃝
“I’m going to ask you some general questions. Let’s begin!” Head of Household Person 2 Person 3 Person 4 Person 5 What are your… Initials? Date of Birth? Age? Head of Household Person 2 Person 3 Person 4 Person 5 How are persons 2 through 5 related to you? [This question is only for the Head of Household] ⃝ Head of Household ⃝ Child ⃝ Spouse or Partner ⃝ Family Member ⃝ Other, non-related ⃝ Child ⃝ Spouse or Partner ⃝ Other Family Member ⃝ Other, non-related ⃝ ⃝ Spouse or Partner ⃝ Family Member ⃝ Other, non-related ⃝ Child ⃝ Spouse or Partner ⃝ Family Member ⃝ Other, non-related Head of Household Person 2 Person 3 Person 4 Person 5 What is your primary race? [Please select one] ⃝ American Indian or Alaskan Native ⃝ Asian ⃝ Black or African American ⃝ Native Hawaiian or Other Pacific Islander ⃝ White ⃝ Doesn’t Know ⃝ Refused ⃝ ⃝ American Indian or Alaskan Native ⃝ Asian ⃝ Black or African American ⃝ Native Hawaiian or Other Pacific Islander ⃝ White ⃝ Know ⃝ Refused ⃝ Other: ⃝ American Indian or Alaskan Native ⃝ Asian ⃝ Black or African American ⃝ Native Hawaiian or Other Pacific Islander ⃝ White ⃝ Doesn’t Know ⃝ Refused ⃝ Other: ⃝ American Indian or Alaskan Native ⃝ Asian ⃝ Black or African American ⃝ Native Hawaiian or Other Pacific Islander ⃝ White ⃝ Doesn’t Know ⃝ Refused ⃝ Other: ⃝ American Indian or Alaskan Native ⃝ Asian ⃝ Black or African American ⃝ Native Hawaiian or Other Pacific Islander ⃝ White ⃝ Know ⃝ Refused ⃝ Other:
2018-Working-Survey-1.docx