Instruments

<<POSTCARD BARCODE>>

The National Opinion Research Center at the University of Chicago (NORC), is conducting an important study sponsored by the U.S. Department of Commerce, Bureau of the Census. Please have an adult (18 years or older) who lives in this household provide a phone number where we may reach you to complete the interview. Your information is protected by law and will remain confidential.

If you have questions or would prefer to complete the interview by phone now, please call NORC toll-free 1-XXX- XXX-XXXX.

1. Please provide us with your ten digit phone number and phone type (home, cellular, work, etc.) so that we may contact you by phone to complete this important study.

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Type:

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2. When is the best time to try to reach you (CHECK ALL THAT APPLY)?

Weekdays Weekends

 9AM - 5PM  9AM - 5PM

 5-7PM  5 - 7PM

 7-9PM  7-9PM

3. What language would you like to use to conduct the interview (CHECK ONE)?

 English  Vietnamese  Russian

 Spanish  Mandarin  Korean

4a. Which of the following best describes your ethnicity?

 Hispanic/Latino origin

 Not of Hispanic/Latino origin

4b.Which of the following best describes your race (CHECK ALL THAT APPLY)?

 White

 Black or African American

 Asian

 Native Hawaiian or other Pacific Islander

 American Indian or Alaskan Native

Once you have provided this information, please fold this card in half, seal it within the enclosed postage paid return envelope and drop it in the mail. Thank you for your participation!

This document has been approved by U.S. Office of Management and Budget (OMB): approval number XXXXXX, expiration date XXXXXX. We could not conduct this study without this approval. This document should take 2 minutes to complete.