PRE-SCREENING QUESTIONNAIRE
Voice your opinion on critical issues that face the country. We're here to listen.
First Name
Last Name
Email
Verify Email
Mobile Phone
In what state or U.S. territory do you live?
[Please select]
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
What is your gender?
[Please select]
Female
Male
What is the highest level of school you have completed or the highest degree you have received?
[Please select]
Less than high school degree
High school degree or equivalent (e.g., GED)
Some college but no degree
Associate degree
Bachelor degree
Graduate degree
Which of the following best describes your total annual household income?
[Please select]
$0 to $9,999
$10,000 to $24,999
$25,000 to $49,999
$50,000 to $74,000
$75,000 to $99,999
$100,000 to $124,999
$125,000 to $149,999
$150,000 to $174,999
$175,000 to $199,999
$200,000 and up
Which of the following best applies to you?
[Please select]
American Indian or Alaskan Native
Asian
Black or African-American
Hispanic or Latino
Native Hawaiian or other Pacific Islander
White
Other
In what year were you born? (enter 4-digit birth year; for example, 1976)
In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)
Enter the code shown
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