1. What is the health insurance premium you pay for a single person per month? Less than $100 $100 - $150 $150 - $200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $450 $450 - $500 More than $500
2. What is the average monthly cost you pay for utilities such as gas,electricity,water,cable and internet? Less than $100 $100 - $150 $150 - $200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $500 More than $500
3. Which US state do you belong to?
4. n what type of an accommodation do you currently live? One bedroom accommodation Two bedroom accommodation Three bedroom accommodation Four bedroom accommodation Five bedroom accommodation
5. How does you spend on Groceries withou coupons A 100-200 B 200-300 C 300-400 D 400-500 E 500-600
6. How Much does you spend on transporation include SUBWAY, BUS,PATh train,and Auto insurance? A 100-200 B 200-300 C 300-400 D 400-500
7. How much do you contribute per month toward your retirement plan(s) and social security?
8. How does you spend on rent,Mortages,and Home insurance? A 1200-1300 B 1400-1500 C 1600-1700 D 1800-1900 E 2000-3000
9. In what industry do you work? Manufacturing Leisure and Hospitality Education Healthcare Financial/Professional Social Service Government Trade Technology Agriculture Real Estate/Construction Transportation
10. Please specify your gender. Male Female
11. In which age-group do you fall? 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 and above.
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