Today's Relationships Survey

Personal

1. What is your Gender?
Male
Female

2. What is your Age?
        Under 18
        18
        19
        20
        21
        22
        23
        Over 23

3. What is your Ethnicity/ Race?
        White/ European American
        African American
        Asian American
        Hispanic American
        Native American
        Other

4. If you selected Other to the previous question, please specify.

5. Are you a United States Citizen?
Yes
No

6. What is your Marital Status?
        Single (If selected please skip question six)
        Dating
        Married
        Divorced
        Separated
        Widow
        Widower

7. What is the Ethnicity/ Race of your partner?
        White/ European American
        African American
        Asian American
        Hispanic American
        Native American
        Other

8. If you selected Other to the previous question, please specify.