The Census Barriers, Attitudes and Motivators Survey (CBAMS) V11
LANDLINE SCREENER
Greeting. Hello, this is ____________ calling from Macro International. We are conducting a brief survey to help plan for the upcoming Census and we’d like to have you participate.
I want to assure you that your answers will be kept completely anonymous. IF NEEDED: I will not ask for your name, address, or other personal information that can identify you. We will only ask for your opinions.
Script for answering machines: CATI DISPLAY ON 2nd and 4th ATTEMPT:
We are conducting a brief survey to help plan for the upcoming Census and we’d like to have you participate. Please call 1-800-XXX-XXXX to let us know what day and time would be convenient for us to call you. Please clearly state your telephone number so we will be able to return your call. Thanks!
S1. May I please speak with the adult in the household who most frequently opens the mail?
[DO NOT READ]
1 Person on the phone is the correct person (Skip to INTRO)
2 Transferred to correct person (Reread greeting; Skip to INTRO)
3 Correct person not available (Thank and schedule callback)
99 Refused (Thank and terminate)
[If S1=3 ASK S1a]
S1a. I would like to call you at a more convenient time. What day and time would be best?
[INTERVIEWER: set up call-back].
CELL PHONE SCREENER
Greeting. Hello, this is ____________ calling from Macro International. We are conducting a brief survey with cell phone users to help plan for the upcoming Census and we’d like to have you participate. As a thank you for your time, we will give you a $10 Amazon.com® gift certificate if you qualify for the survey and complete the interview.
I want to assure you your answers will be kept completely anonymous. IF NEEDED: I will not ask for your name, address, or other personal information that can identify you. We will only ask for your opinions.
Script for answering machines: CATI DISPLAY ON 2nd and 4th ATTEMPT:
We are conducting a brief survey with cell phone users to help plan for the upcoming Census. We’d like to have you participate. As a thank you for your time, we will give you a $10 Amazon.com® gift certificate if you qualify for the survey. Please call 1-800-XXX-XXXX to let us know what day and time would be convenient for us to call you. Please clearly state your telephone number so we will be able to return your call. Thanks!
S1. Your safety is important. Are you driving in a car, walking down the street, in a public place or other location where talking on the phone might distract you or jeopardize your safety?
1 Yes (Thank and schedule callback)
2 No
99 Refused (Thank and terminate)
[If S1=1 ASK S1a]
S1a. I would like to call you at a more convenient time. What day and time would be best?
[INTERVIEWER: set up call-back].
S2. What is your age?
__ years old [90=90 or more]
98 Don’t know
99 Refused
[IF S2<18 THANK AND TERMINATE; IF S2=98, 99 ASK S2a; 18<=S2<=90 GO TO INTRO]
S2a. In which of these age categories do you belong?
[READ LIST]
0 Less than 18
1 18-24
2 25-34
3 35-44
4 45-54
5 55-64
6 65 or older
[DO NOT READ]
99 Refused
[IF S2a=0 THANK AND TERMINATE; IF S2a=99 ASK S2b; IF S2a=1, 2, 3, 4, 5, 6 GO TO S3]
S2b. Are you at least 18 years old?
1 Yes
2 No (Thank and terminate)
99 Refused (Thank and terminate)
[If S2b=2, 99 THANK AND TERMINATE; OTHERWISE GO TO S3]
S3. Are you the person who most frequently opens the mail for your household?
1 Yes
2 No
98 Don’t know
99 Refused
INTRO
Your participation in this survey is voluntary, but your responses are important. You can choose not to answer any question and you can end the interview at any time. The survey takes approximately 20 to 25 minutes to complete. It has been approved by U.S. Office of Management and Budget approval number 0607-xxxx, expiring on MMM DD, YYYY. Without this number, we could not conduct this survey.
If you have any questions about this survey, please call 1-XXX-XXX-XXXX. If you have comments about the survey, you may send them to an address I will provide at the conclusion. This call may be monitored for quality assurance.
A. UNAIDED AWARENESS
A1. Have you ever heard of the Census of the United States?
Yes
No (skip to A3)
[DO NOT READ]
Don’t Know (skip to A3)
Refused (skip to A3)
A2. In your own words, how would you describe what the purpose of the Census of the United States is?
Record Answer
[Go to B1]
[If A1=2,98,99]
A3. The Census is the count of all the people who live in the United States. Have you ever heard of that before?
Yes (skip to B1)
No
[DO NOT READ]
Don’t know
Refused
[READ ONLY IF A3=2,98,99]
A4. The Census, which will be carried out in 2010, collects information from households to determine representation in Congress and help local communities plan for improvements. Based on that information, how likely are you to participate? By participate, we mean fill out and mail in a Census form. Would you say you…?
[READ LIST, RECORD ONE ANSWER]
5 Definitely will
4 Probably will
3 Might or might not
2 Probably will not
Definitely will not
[DO NOT READ]
Don’t know
Refused
[READ ONLY IF A4=3,2,1,98,99]
A5. Could you explain why you wouldn’t mail in your Census form?
Record Answer
[IF A4=3, 4, 5, 98, 99 GO TO F1; IF A4=1, 2 GO TO H1]
B. INTENT
B1. If the Census were held today, how likely are you to participate? By participate, we mean fill out and mail in a Census form. Would you say you…?
[READ LIST, RECORD ONE ANSWER]
Definitely will
Probably will
3 Might or might not
2 Probably will not
Definitely will not
[DO NOT READ]
Don’t know
99 Refused
[ASK B2 IF B1=3,2,1,98,99]
B2. Could you explain why you might not mail in your Census form?
Record Answer
B3. How likely are you to recommend participating in the Census to a family member or friend? Would you say you…?
[READ LIST, RECORD ONE ANSWER]
Definitely will
Probably will
3 Might or might not
2 Probably will not
1 Definitely will not
[DO NOT READ]
98 Don’t know
99 Refused
[READ ONLY IF B3=3,2,1,98,99]
B4. Could you explain why you might not recommend participating in the 2010 Census?
Record Answer
B5. Thinking about the Census overall, how important do you feel it is for you to participate in the Census? Would you say it is…?
[READ LIST, RECORD ONE ANSWER]
4 Very important
3 Somewhat important
2 Not too important
1 Not at all important
[DO NOT READ]
98 Don’t know
99 Refused
C. AWARENESS
C1. Have you seen or heard anything recently—within the last month or so—about the Census?
Yes
No
[DO NOT READ]
Don’t Know
Refused
C2. Overall, how would you describe your general feelings about the Census? Do you feel…?
[READ LIST, RECORD ONE ANSWER]
5 Highly favorable
4 Moderately favorable
Neutral
2 Not too favorable
1 Rather unfavorable
[DO NOT READ]
98 Don’t know
99 Refused
C3. In general, how familiar are you with the way Census data impacts you and your community. Would you say…?
[READ LIST, RECORD ONE ANSWER]
4 Very familiar
3 Somewhat familiar
2 Not very familiar
Not familiar at all
[DO NOT READ]
Don’t know
99 Refused
C4. People have different ideas about what the Census is used for. I am going to read some of them to you. As I read each one, please tell me by indicating yes or no whether you think that the Census is used for that purpose. Is the Census used…?
[PLEASE READ]
Yes
No
Don’t Know
[DO NOT READ]
Refused
[ROTATE LIST]
To decide how much money communities will get from the government?
To decide how many representatives each state will have in Congress?
To see what changes have taken place in the size, location and characteristics of the people in the United States?
To determine property taxes?
To help the police and FBI keep track of people who break the law?
To help businesses and governments plan for the future?
To locate people living in the country illegally?
To determine state income tax rates?
To count both citizens and non–citizens?
To determine the rate of unemployment
C6. Most people will receive their Census form in the mail. Are you aware that if you don’t mail back the Census form that a Census Bureau interviewer will try to visit your home to gather the necessary information?
Yes
No
[DO NOT READ]
98 Don’t Know
99 Refused
C7. The Census Bureau Interviewer who visits your home will show proper identification. How comfortable would you be allowing a Census Bureau interviewer to collect your answers at your doorstep? Would you be…?
[READ LIST, RECORD ONE ANSWER]
4 Very Comfortable
3 Somewhat Comfortable
2 Somewhat Uncomfortable
1 Very Uncomfortable
[DO NOT READ]
97 Neither comfortable nor uncomfortable
Don’t Know
99 Refused
D. LEGAL ISSUES
D1. As far as you know, does the law require you to answer the Census questions?
1 Yes, its required
2 No, it is not required
[DO NOT READ]
98 Don’t know
99 Refused
D2. As far as you know, is the Census Bureau required by law to keep information confidential?
Yes, its required
No, it is not required
[DO NOT READ]
Don’t know
Refused
E. Attitudes
E1. Next I’m going to read some opinions that some people may have about the Census. As I read each one please tell me if you strongly agree, agree, disagree, or strongly disagree.
[READ LIST, RECORD ONE ANSWER]
4 Strongly agree
3 Agree
Disagree
Strongly disagree
[DO NOT READ]
97 Neither agree nor disagree/No opinion
98 Don’t know
99 Refused
[ROTATE LIST]
The Census is an invasion of privacy.
It is important for everyone to be counted in the Census.
The Census Bureau would never let another government agency see my answers to the Census.
People’s answers to the Census cannot be used against them.
Taking part in the Census shows I am proud of who I am.
Filling out the Census form will let the government know what my community needs.
I just don’t see that it matters much if I personally fill out the Census form or not.
It is a civic responsibility to fill out the Census form.
The Census Bureau’s promise of confidentiality can be trusted.
I am concerned that the information I provide will be misused.
I prefer to stay out of sight and not be counted.
The government already has my personal information, like my tax returns, so I don’t need to fill out a Census form.
I’ll never see results from the Census in my neighborhood.
It takes too long to fill out the Census information, I don’t have time.
I don’t like to fill out paper forms or use the mail because I prefer to do everything online.
The Census is only for people who speak English.
Computer “hackers” could obtain Census information about you if they really tried.
F. Potential Motivators
F1. The following are true statements about the Census. We would like to know the degree to which these facts affect your likelihood to participate in 2010 Census. Does knowing each of the following make you more likely to participate, less likely to participate, or wouldn’t affect your participation? The first one is…
[READ LIST AS NECESSARY, RECORD ONE ANSWER]
3 More likely to participate
2 Less likely to participate
1 Wouldn’t affect your participation
[DO NOT READ]
Don’t know
Refused
[ROTATE LIST]
Census counts decide a community’s share of $300 billion in federal funds for schools and other programs
The Census determines the number of representatives in Congress each state gets
The law requires everyone to participate in the Census.
Filling out the Census provides an opportunity to help people in your local community get certain benefits, such as healthcare, school programs, day care and job training
Information from the Census helps the government plan for the future improvements to schools, roads, fire and police stations
If you don’t fill out your Census form, your family and local community might not get their fair share of benefits
To see what changes have taken place in the size, location and characteristics of the people in the United States
The Census 2010 form doesn’t ask for sensitive information, it only asks a few questions such as name, sex, age, date of birth, how people are related, race and origin
The Census is more accurate if everyone participates
U.S. Census employees are subject to jail term, a fine, or both, for disclosing personal information
Mailing your Census form early helps the government save millions in taxpayer dollars that would otherwise go toward following up with you if you don’t mail it back
G. RANKING MESSAGES
G1. Your participation in the Census helps determine funding for a number of programs and services. I am going to read you a list of programs and services. Please rate how important funding of each one is to you, using a scale of 1 to 5, where 1 is not at all important and 5 is very important.
5 Very important
4
3
2
Not at all important
[DO NOT READ]
98 Don’t know
99 Refused
[ROTATE LIST]
Schools and the education system
Hospitals and healthcare
Care for the elderly
4 Roads and highways
5 Job training programs
6 Daycare for children
7 Public transportation
8 Fire and police stations
9 Political representation in Congress
H. CIVIC PARTICIPATION
H1. I am going to read you a list of activities. Please tell me whether or not you participated in the activity in the last 12 months. [As needed: By participation, I mean attending meetings or working at sponsored events.]
1 Yes
2 No
[DO NOT READ]
Don’t know
Refused
[ROTATE LIST]
A school group, neighborhood, or community association such as PTA or neighborhood watch group? [As needed: Did you participate in this kind of activity in the past 12 months?]
A service or civic organization such as American Legion or Lion’s Club? [As needed: Did you participate in this kind of activity in the past 12 months?]
A church, synagogue, mosque or other religious institution or organization? [As needed: Did you participate in this kind of activity in the past 12 months?]
A blood drive? [As needed: Did you participate in this kind of activity in the past 12 months?]
Any other type of organization that I have not mentioned? [As needed: Did you participate in this kind of activity in the past 12 months?]
H1a. Please tell me how often you participated in…
[DO NOT READ, RECORD ONE ANSWER]
Once a year
Several times a year
Once a month
Several times a month
Once a week
98 Don’t know
Refused
[LIST ‘Yes’ responses from H1]
H2. How often do you vote in elections?
[READ LIST, RECORD ONE ANSWER]
5 Always
4 Almost always
3 Usually
2 Seldom
Never
[DO NOT READ]
Don’t know
Refused
H3. Now I am going to read you a list of information sources. Please tell me which of these are sources that you’d depend on for information.
Yes
No
[DO NOT READ]
98 Don’t know
99 Refused
Would you depend on…
[ROTATE LIST]
Television [If needed: Would you depend on this source for information – yes or no?]
Newspapers [If needed: Would you depend on this source for information – yes or no?]
Radio [If needed: Would you depend on this source for information – yes or no?]
Internet or websites [If needed: Would you depend on this source for information – yes or no?]
Local or community leaders [If needed: Would you depend on this source for information – yes or no?]
Friends or Family [If needed: Would you depend on this source for information – yes or no?]
Religious Leaders, churches, religious or faith-based groups [If needed: Would you depend on this source for information – yes or no?]
Government Officials [If needed: Would you depend on this source for information – yes or no?]
TV or radio talk shows [If needed: Would you depend on this source for information – yes or no?]
AARP [If needed: Would you depend on this source for information – yes or no?]
Ethnic or race-based organizations (e.g., NAACP, Tribal Pow-wows) [If needed: Would you depend on this source for information – yes or no?]
Entertainers, celebrities, or other personalities [If needed: Would you depend on this source for information – yes or no?]
Local town hall meetings [If needed: Would you depend on this source for information – yes or no?]
Neighborhood businesses or gathering places [If needed: Would you depend on this source for information – yes or no?]
Military or veterans organizations (e.g., VFW, American Legion) [If needed: Would you depend on this source for information – yes or no?]
Unions or union leaders [If needed: Would you depend on this source for information – yes or no?]
Some other source – specify [If needed: Would you depend on this source for information – yes or no?]
H4. Now I’d like you to think about obtaining information about the census. I am going to read to you the list of sources you said you depend on for information. After each one, please rate the importance to you, using a scale of 1 to 5, where 1 is not at all important and 5 is very important. How important is...?
5 Very important
4
3
2
Not at all important
[DO NOT READ]
98 Don’t know
99 Refused
[READ LIST]
[LIST ‘Yes’ responses from H3] [If needed: How important to you is this for obtaining information about the Census?]
I. DEGREE OF COMMUNITY “STAKEDNESS”/ATTACHMENT
I1. Please indicate your level of agreement or disagreement with the following statements.
[READ LIST, RECORD ONE ANSWER]
4 Strongly agree
3 Agree
2 Disagree
1 Strongly disagree
[DO NOT READ]
97 Neither agree nor disagree/No opinion
98 Don’t know
99 Refused
[ROTATE LIST]
I feel like part of my neighborhood and community
I know many of my neighbors
If I had to move away from my neighborhood, I would miss it
I2. How long have you lived at your address?
[READ LIST IF NECESSARY, RECORD ONE ANSWER]
Less than 1 year
1-3 years
4-7 years
8-10 years
More than 10 but not whole life
All of my life
[DO NOT READ]
Don’t know
Refused
J. MEDIA EXPOSURE
J1. On the average day, about how many hours do you watch television?
[READ LIST IF NECESSARY]
0 None
1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
More than 10 hours
[DO NOT READ]
Don’t know
Refused
[ASK J2 ONLY IF J1=1-11]
J2. Now I’m going to read you some types of television programs. Please tell me if you watch each.
1 Yes
2 No
[DO NOT READ]
98 Don’t know
99 Refused
[READ AND ROTATE LIST 1-11]
Local news
National news
Sports
Sitcoms
Dramas
Soap operas
Reality TV (e.g Survivor)
Talk Shows (Oprah, Sally Jesse Raphael)
Political Talk Shows (Meet the Press, Larry King)
Movies
Game Shows
[DO NOT READ]
Other________ (Record Answer)
Don’t know
Refused
[ASK J2a IF MORE THAN 3 SELECTIONS IN J2]
J2a. Of the types of programs you watch, please tell me which three you watch the most.
[READ LIST IF NECESSARY; ALLOW UP TO 3 RESPONSES]
[LIST ‘Yes’ responses from J2]
J3. On the average day, about how many hours do you spend listening to the radio?
[READ LIST IF NECESSARY]
0 None
1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
More than 10 hours
[DO NOT READ]
Don’t know
Refused
[ASK J4 ONLY IF J3=1-11]
J4. Now I’m going to read you some types of radio programs. Please tell me if you listen to each.
[READ AND ROTATE 1-6, RECORD UP TO THREE ANSWERS]
Music
News
Sports
Sports talk shows
Political talk shows
Religious talk shows
Other talk shows
[DO NOT READ]
Don’t know
Refused
[ASK J3a IF MORE THAN 3 SELECTIONS IN J3]
J3a. Of the types of programs you listen to, please tell me which three you listen to the most.
[READ LIST IF NECESSARY; ALLOW UP TO 3 RESPONSES]
[LIST ‘Yes’ responses from J3]
J5. Do you currently subscribe to satellite radio?
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
J6. How often do you read the newspaper, either in paper form or on the internet?
[READ LIST IF NECESSARY]
1 Every day
2 A few times a week
3 Once a week
4 Less than once a week
5 Never
[DO NOT READ]
98 Don’t know
99 Refused
J7. On average, do you read one magazine a month, more than one, or none?
[Do NOT READ LIST]
1 1 magazine
2 More than one
3 None; I do not read magazines
[DO NOT READ]
98 Don’t know
99 Refused
J8. On an average day, about how many hours do you use the Internet either at home, work or somewhere else?
0 None [Interviewer: 0 = Respondent does not use Internet or does not have Internet]
1 Hour
2 Hours
3 Hours
4 Hours
5 Hours
6 Hours
7 Hours
8 Hours
9 Hours
10 Hours
More than 10 hours
[DO NOT READ]
98 Don’t know
99 Refused
[ASK J9-J 11 ONLY IF J8=01-11]
J9. For the following activities or types of web sites, please indicate how often you use or visit them.
[READ LIST]
5 Very often
4 Often
3 Somewhat often
2 Not very often
1 Not at all
[DO NOT READ]
98 Don’t know
99 Refused
[ROTATE LIST]
News, map directions, job hunting, reviews, or other information research or gathering.
Myspace, Facebook, blogging, or other social networking.
Paying bills, shopping or other financial transactions
Emailing, instant messaging, telephone calls or other means of communication
Viewing videos, downloading music or podcasts, or other forms of entertainment.
J10. How often do you click on advertisements on internet web sites?
Very often
Sometimes
Not very often
Never
[DO NOT READ]
Don’t know
Refused
J11a. When you are online, would you expect to locate information about the Census in search engines?
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
J11b. How about banner adds? [IF NEEDED: When you are online, would you expect to locate information about the Census in banner ads?]
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
J11c. How about emails? [IF NEEDED: When you are online, would you expect to locate information about the Census in emails?]
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
J11d. How about social networking sites? [IF NEEDED: When you are online, would you expect to locate information about the Census on social networking sites?]
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
J11e. How about bulletin and message boards ? [IF NEEDED: When you are online, would you expect to locate information about the Census on bulletin and message boards?]
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
K. PAST PERSONAL CENSUS EXPERIENCE
Now I am going to ask you a few questions about your experience with the most recent U.S. Census in the year 2000.
K1. Do you recall receiving the 2000 Census form?
Yes
No
[DO NOT READ]
Don’t Know
Refused
[IF K1=2, 98, 99 GO TO L]
K1a. If you can remember, did you complete and return the Census form?
Yes
No
[DO NOT READ]
97 Completed during a personal visit
Don’t Know
Refused
L. PHONE QUESTIONS
Cell phone/landline questions—will depend on the collection modes.
For Cell Phone Survey
L2. In addition to your cell phone, is there at least one telephone inside your home that is
currently working and is not a cell phone? Do not include telephones only used for business or
telephones only used for computers or fax machines.
Yes (DUAL USER)
No (CELL ONLY)
[DO NOT READ]
Don’t know (CELL ONLY)
Refused (UNCLASSIFIED)
[ASK L2a IF L2=1]
L2a. How many? [IF NEEDED: Telephone lines inside your home.]
__ Telephones [6 = 6 or more]
[DO NOT READ]
98 Don’t know
99 Refused
For Landline Survey
L3. In addition to your residential landline telephone, do you also use one or more cell phone numbers?
Yes(DUAL USER)
No (LANDLINE ONLY)
[DO NOT READ]
98 Don’t know (LANDLINE ONLY)
99 Refused (UNCLASSIFIED)
[ASK L3a IF L3=1]
L3a. How many? [IF NEEDED: Cell phones do you use.]
__ Cell phones [6 = 6 or more]
[DO NOT READ]
98 Don’t know
99 Refused
For In-person survey
L4. Is there at least one telephone line inside your home that is currently working and is not a cell phone? Do not include telephones only used for business or telephones only used for computers or fax machines.
Yes
No
[DO NOT READ]
Don’t know
Refused
[ASK L4a IF L4=1]
L4a. How many? [IF NEEDED: Telephone lines inside your home.]
__ Telephones [6 = 6 or more]
[DO NOT READ]
98 Don’t know
99 Refused
L5. Do you use one or more cell phone numbers?
Yes
No
Don’t know
Refused
[ASK L5a IF L5=1]
L5a. How many? [IF NEEDED: Cell phones do you use.]
__ Cell phones [6 = 6 or more]
[DO NOT READ]
98 Don’t know
99 Refused
IF L4=1 AND L5=1 THEN DUAL USER
IF L4=2 AND L5=1 THEN CELL ONLY
IF L4=1 AND L5=2 THEN LANDLINE ONLY
IF L4=2 AND L5=2 THEN NO PHONE
ALL OTHERS ARE UNCLASSIFIED
[ASK L6 DUAL USER OR UNCLASSIFIED]
L6. Of all the telephone calls that you receive, are …
[READ LIST]
01 All or almost all calls received on a cell phone?
02 Some received on a cell phone and some on a regular landline phone?
03 Very few or none received on a cell phone?
[DO NOT READ]
87 Don’t have a regular landline phone (CELL ONLY)
88 Don’t have a cell phone (LANDLINE ONLY)
89 Don’t have any phone (NO PHONE)
98 Don’t know
99 Refused
[ASK L7 IF CELL ONLY, DUAL USER OR UNCLASSIFIED]
L7. Do you use your cell phone for anything besides making and receiving phone calls?
1 Yes
2 No
[DO NOT READ]
98 Don’t Know
99 Refused
[IF L7=1 THEN ASK L7a]
L7a. Please select how often you perform the following activities on your cell phone?
[READ LIST IF NECESSARY]
5 Very often
4 Often
3 Somewhat often
2 Not very often
1 Not at all
[DO NOT READ]
88 Don’t have a cell phone (LANDLINE ONLY; SKIP TO M)
98 Don’t know
99 Refused
[ROTATE LIST]
Text Messaging
Widgets
Emailing
Photos
Internet
Multmedia
Music
Podcast
Video
M. DEMOGRAPHICS
Now I am going to ask you some questions regarding your demographic information.
M1. Including yourself, how many people live in your household?
Record Answer [must topcode recorded answers at 20]
M2. Do you have children in school who are under 18 living at home with you?
Yes
No
[DO NOT READ]
Don’t Know
Refused
M3. What is your marital status?
1 Now married
2 Widowed
3 Divorced
4 Separated
5 Never married
[DO NOT READ]
98 Don’t Know
99 Refused
M4. What is the highest grade or year of regular school you completed?
[READ LIST IF NECESSARY]
1 Less than grade school
2 Less than high school graduate
3 High school graduate
4 Some college
5 College graduate
6 Postgraduate
[DO NOT READ]
98 Don’t Know
99 Refused
M5. Are you Hispanic or Latino?
Yes
No
[DO NOT READ]
Don’t Know
Refused
M6. Which of these categories best describes your race?
[READ LIST, ALLOW MULTIPLE RESPONSES]
1 American Indian or Alaska Native
2 Asian
3 Native Hawaiian or other Pacific Islander
4 Black or African-American
5 White
[DO NOT READ]
6 Other
98 Don’t Know
99 Refused
M7. What language is spoken most often in this household?
[READ LIST IF NECESSARY]
English
Spanish
An Asian or Pacific Islander language (e.g., Chinese, Japanese, Tagalog, Vietnamese)
Other
[DO NOT READ]
98 Don’t Know
99 Refused
M8. Were you born in the United States?
Yes
No
[DO NOT READ]
Don’t Know
Refused
M9. Do you rent or own your house/apartment?
1 Rent
2 Own
[DO NOT READ]
3 Other
98 Don’t Know
99 Refused
M10. For last year- 2007- what was the total income of your household BEFORE TAXES?
[READ LIST IF NECESSARY]
1 Less than $25,000
2 $25,000 to less than $50,000
3 $50,000 to less than $75,000
4 $75,000 or more
[DO NOT READ]
98 Don’t know
99 Refused
[IF CELL PHONE SURVEY GO TO M12]
M11. What is your age?
__ years old [90=90 or more]
[DO NOT READ]
98 Don’t know
99 Refused
[IF M11=98, 99 ASK M11a]
M11a. In which of these age categories do you belong?
[READ LIST]
1 18-24
2 25-34
3 35-44
4 45-54
5 55-64
6 65 or older
[DO NOT READ]
99 Refused
M12. Sex of respondent [RECORD; ASK ONLY IF UNSURE]
1 Male
2 Female
PSYCHO-GRAPHIC QUESTIONS
N1. Now I am going to read you a few statements. Please tell me if you agree a lot, a little, neither, disagree a little, or disagree a lot with the following statements…
[READ LIST IF NECESSARY]
Agree a lot
Agree a little
Neither agree nor disagree
Disagree a little
Disagree a lot
[DO NOT READ]
98 Don’t Know
99 Refused
[ROTATE LIST; [DO NOT ASK a-d IF J8=00]
I like to go to websites I have never been to before
I like websites that protect my privacy
I spend less time watching television on my television set because of the internet
When I need information the first place I look is the internet
I try to keep up with developments in technology
My friends often ask for my advice before buying electronic equipment
I keep up to date with the latest fashion trends
CLOSING
That was my last question. Thank you for your time and effort today. Do you want the address where you can provide comments on this survey?
IF NEEDED: Send comments regarding this burden estimate or any other aspect of this collection of information to: Paperwork Project 0607-XXXX, U.S. Census Bureau, 4600 Silver Hill Road, Room 3K138, Washington, DC 20233. You may e-mail comments to Paperwork@census.gov; use "Paperwork Project 0607-XXXX" as the subject.
File Type | application/msword |
File Title | Census Participation Survey |
Author | Todd.Hamlin |
Last Modified By | randal.s.zuwallack |
File Modified | 2008-05-30 |
File Created | 2008-05-30 |