Cognitive Interviews for Education Longitudinal Study of 2002 Third Follow-up 2012 (ELS:2002/12) Survey Draft Items

Education Longitudinal Study of 2002 Third Follow-up 2012 (ELS:2002/12)

2010 Cognitive Interviews

Attachment III

Participant Information Sheet

Cognitive Interview Participant Information Form

Thank you for participating in a cognitive interview. Prior to beginning, please provide the following information about yourself. This information is requested so that we can learn about those participating in the interview. This information will not be shared with anyone other than those conducting the interview.

Completing this information is strictly voluntary on your part.

Age: ____________ years old Gender: ₁ Male ₂ Female

Are you of either Hispanic or Latino origin?

₁ Yes

₂ No

What is your race? (Please check one or more.)

₁ American Indian or Alaska Native
₂ Asian
₃ Black or African American
₄ Native Hawaiian or Other Pacific Islander

₅ White

Thank you for providing this information.