782 2014 782 Architect of the US Capitol Tour

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Overview

Welcome and Thank You Text
Current Model Qsts
MQs V1 Qsts 1&2
MQs V2 Qsts 1&3
MQs V3 Qsts 2&3
Custom Questions (All)

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Sheet 1: Welcome and Thank You Text

Model Instance Name:
CVC Tour
MID:	MswBBENZcR8FIZ4o1RFBIw==
Date:	2/21/2012
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome text shown in the box below.
					Examples
					Welcome Text Example
	Welcome Text
	Thank you for your willingness to provide feedback to the U.S. Capitol Visitor Center! You have been selected to take a survey about the Tour of the U.S. Capitol. The survey will include very specific questions about the tour, as well as general questions about you and your entire Capitol Visitor Center experience. This survey will let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best experience possible while at the U.S. Capitol.
					Thank You Text Example
	Thank You Text
	Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.

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Sheet 2: Current Model Qsts

Model Instance Name:
CVC Tour
MID: MswBBENZcR8FIZ4o1RFBIw==
Partitioned (Y/N)? N
Date:	2/27/2012
CVC Tour
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	US Government (1=Poor, 10=Excellent)		Satisfaction		Return (1=Very Unlikely, 10=Very Likely)
1	U.S. Capitol Tour and Government - How well did the U.S. Capitol Tour... Foster connections between citizens and their government.	22	What is your overall satisfaction with the U.S. Capitol Tour? (1=Very Dissatisfied, 10=Very Satisfied)	25	How likely are you to return to the U.S. Capitol Visitor Center?
2	Enhance understanding of the legislative branch of government.	23	How well does this tour meet your expectations? (1=Falls Short, 10=Exceeds)		Recommend (1=Very Unlikely, 10=Very Likely)
3	Explain the different roles and responsibilities of the House and Senate.	24	How does this tour compare to your idea of an ideal tour? (1=Not Very Close, 10=Very Close)	26	How likely are you to recommend the U.S. Capitol Tour to someone else?
	Capitol History (1=Poor, 10=Excellent)				Perception (1=Very Unlikely, 10=Very Likely)
4	U.S. History and the U.S. Capitol Tour - How well did the presented information ... Arouse curiosity in the history of the United States, Congress and the Capitol.			27	How likely are you to improve your perception of the U.S. Capitol Visitor Center as a result of taking the tour?
5	Develop context about important people, places, and events in U.S. history.				Future Participation (1=Very Unlikely, 10=Very Likely)
6	Increase understanding of the role of citizen involvement to develop the United States.			28	How likely are you to express your thoughts about the U.S. Capitol Visitor Center in the next 90 days?
	Tour Content (1=Strongly Disagree, 10=Strongly Agree)				Community Service (1=Very Unlikely, 10=Very Likely)
7	Please rate your level of agreement with the following statements: The tour advanced my knowledge and understanding of the U.S. government.			29	How likely are you to donate time and effort to community service in your local area?
8	The tour is a helpful experience toward understanding U.S. history.
9	The tour covers its objectives.
	Communication (1=Poor, 10=Excellent)
10	Thinking about your tour guide, please rate how well the guide performed in the following areas: Communication Tour guide's understanding of your questions during the tour.
11	Accuracy of information provided about things viewed at the Capitol.
12	Ability to clearly communicate content and information throughout the tour.
	Engagement (1=Poor, 10=Excellent)
13	Engagement Friendliness when speaking.
14	Promptness to acknowledge questions and comments.
15	Respect for traditions, cultures, and needs of visitors and guests.
	Interactivity (1=Poor, 10=Excellent)
16	Interactivity The ability of the guide to engage in discussions.
17	The capacity to connect content with questions and discussions during the tour.
18	The skill of the guide to create involvement among members of the tour group.
	Tour Guide (1=Strongly Disagree, 10=Strongly Agree)
19	Please rate your level of agreement with the following statements: The tour guide demonstrated professionalism throughout the tour.
20	The tour guide was responsive to the questions and needs arising during the tour.
21	The tour guide was enthusiastic about my participation at the U.S. Capitol.

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Sheet 3: MQs V1 Qsts 1&2

Model Instance Name:
CVC Tour
MID: xBo8QV1YcARw0ot8d18A1w4C
Partitioned (Y/N)? N
Date:	2/27/2012
CVC Tour V1
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	US Government (1=Poor, 10=Excellent)		Satisfaction		Return (1=Very Unlikely, 10=Very Likely)
1	U.S. Capitol Tour and Government - How well did the U.S. Capitol Tour... Foster connections between citizens and their government.	22	What is your overall satisfaction with the U.S. Capitol Tour? (1=Very Dissatisfied, 10=Very Satisfied)	25	How likely are you to return to the U.S. Capitol Visitor Center?
2	Enhance understanding of the legislative branch of government.	23	How well does this tour meet your expectations? (1=Falls Short, 10=Exceeds)		Recommend (1=Very Unlikely, 10=Very Likely)
	Capitol History (1=Poor, 10=Excellent)	24	How does this tour compare to your idea of an ideal tour? (1=Not Very Close, 10=Very Close)	26	How likely are you to recommend the U.S. Capitol Tour to someone else?
4	U.S. History and the U.S. Capitol Tour - How well did the presented information ... Arouse curiosity in the history of the United States, Congress and the Capitol.				Perception (1=Very Unlikely, 10=Very Likely)
5	Develop context about important people, places, and events in U.S. history.			27	How likely are you to improve your perception of the U.S. Capitol Visitor Center as a result of taking the tour?
	Tour Content (1=Strongly Disagree, 10=Strongly Agree)				Future Participation (1=Very Unlikely, 10=Very Likely)
7	Please rate your level of agreement with the following statements: The tour advanced my knowledge and understanding of the U.S. government.			28	How likely are you to express your thoughts about the U.S. Capitol Visitor Center in the next 90 days?
8	The tour is a helpful experience toward understanding U.S. history.				Community Service (1=Very Unlikely, 10=Very Likely)
	Communication (1=Poor, 10=Excellent)			29	How likely are you to donate time and effort to community service in your local area?
10	Thinking about your tour guide, please rate how well the guide performed in the following areas: Communication Tour guide's understanding of your questions during the tour.
11	Accuracy of information provided about things viewed at the Capitol.
	Engagement (1=Poor, 10=Excellent)
13	Engagement Friendliness when speaking.
14	Promptness to acknowledge questions and comments.
	Interactivity (1=Poor, 10=Excellent)
16	Interactivity The ability of the guide to engage in discussions.
17	The capacity to connect content with questions and discussions during the tour.
	Tour Guide (1=Strongly Disagree, 10=Strongly Agree)
19	Please rate your level of agreement with the following statements: The tour guide demonstrated professionalism throughout the tour.
20	The tour guide was responsive to the questions and needs arising during the tour.

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Sheet 4: MQs V2 Qsts 1&3

Model Instance Name:
CVC Tour
MID: odkNoYU1QAMwYsME1hQgJQ4C
Partitioned (Y/N)? N
Date:	2/27/2012
CVC Tour V2
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	US Government (1=Poor, 10=Excellent)		Satisfaction		Return (1=Very Unlikely, 10=Very Likely)
1	U.S. Capitol Tour and Government - How well did the U.S. Capitol Tour... Foster connections between citizens and their government.	22	What is your overall satisfaction with the U.S. Capitol Tour? (1=Very Dissatisfied, 10=Very Satisfied)	25	How likely are you to return to the U.S. Capitol Visitor Center?
3	Explain the different roles and responsibilities of the House and Senate.	23	How well does this tour meet your expectations? (1=Falls Short, 10=Exceeds)		Recommend (1=Very Unlikely, 10=Very Likely)
	Capitol History (1=Poor, 10=Excellent)	24	How does this tour compare to your idea of an ideal tour? (1=Not Very Close, 10=Very Close)	26	How likely are you to recommend the U.S. Capitol Tour to someone else?
4	U.S. History and the U.S. Capitol Tour - How well did the presented information ... Arouse curiosity in the history of the United States, Congress and the Capitol.				Perception (1=Very Unlikely, 10=Very Likely)
6	Increase understanding of the role of citizen involvement to develop the United States.			27	How likely are you to improve your perception of the U.S. Capitol Visitor Center as a result of taking the tour?
	Tour Content (1=Strongly Disagree, 10=Strongly Agree)				Future Participation (1=Very Unlikely, 10=Very Likely)
7	Please rate your level of agreement with the following statements: The tour advanced my knowledge and understanding of the U.S. government.			28	How likely are you to express your thoughts about the U.S. Capitol Visitor Center in the next 90 days?
9	The tour covers its objectives.				Community Service (1=Very Unlikely, 10=Very Likely)
	Communication (1=Poor, 10=Excellent)			29	How likely are you to donate time and effort to community service in your local area?
10	Thinking about your tour guide, please rate how well the guide performed in the following areas: Communication Tour guide's understanding of your questions during the tour.
12	Ability to clearly communicate content and information throughout the tour.
	Engagement (1=Poor, 10=Excellent)
13	Engagement Friendliness when speaking.
15	Respect for traditions, cultures, and needs of visitors and guests.
	Interactivity (1=Poor, 10=Excellent)
16	Interactivity The ability of the guide to engage in discussions.
18	The skill of the guide to create involvement among members of the tour group.
	Tour Guide (1=Strongly Disagree, 10=Strongly Agree)
19	Please rate your level of agreement with the following statements: The tour guide demonstrated professionalism throughout the tour.
21	The tour guide was enthusiastic about my participation at the U.S. Capitol.

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Sheet 5: MQs V3 Qsts 2&3

Model Instance Name:
CVC Tour
MID: F01I09IQJNUQoI80sJl9Zg4C
Partitioned (Y/N)? N
Date:	2/27/2012
CVC Tour V3
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	US Government (1=Poor, 10=Excellent)		Satisfaction		Return (1=Very Unlikely, 10=Very Likely)
2	U.S. Capitol Tour and Government - How well did the U.S. Capitol Tour… Enhance understanding of the legislative branch of government.	22	What is your overall satisfaction with the U.S. Capitol Tour? (1=Very Dissatisfied, 10=Very Satisfied)	25	How likely are you to return to the U.S. Capitol Visitor Center?
3	Explain the different roles and responsibilities of the House and Senate.	23	How well does this tour meet your expectations? (1=Falls Short, 10=Exceeds)		Recommend (1=Very Unlikely, 10=Very Likely)
	Capitol History (1=Poor, 10=Excellent)	24	How does this tour compare to your idea of an ideal tour? (1=Not Very Close, 10=Very Close)	26	How likely are you to recommend the U.S. Capitol Tour to someone else?
5	U.S. History and the U.S. Capitol Tour - How well did the presented information … Develop context about important people, places, and events in U.S. history.				Perception (1=Very Unlikely, 10=Very Likely)
6	Increase understanding of the role of citizen involvement to develop the United States.			27	How likely are you to improve your perception of the U.S. Capitol Visitor Center as a result of taking the tour?
	Tour Content (1=Strongly Disagree, 10=Strongly Agree)				Future Participation (1=Very Unlikely, 10=Very Likely)
8	Please rate your level of agreement with the following statements: The tour is a helpful experience toward understanding U.S. history.			28	How likely are you to express your thoughts about the U.S. Capitol Visitor Center in the next 90 days?
9	The tour covers its objectives.				Community Service (1=Very Unlikely, 10=Very Likely)
	Communication (1=Poor, 10=Excellent)			29	How likely are you to donate time and effort to community service in your local area?
11	Thinking about your tour guide, please rate how well the guide performed in the following areas: Communication - Accuracy of information provided about things viewed at the Capitol.
12	Ability to clearly communicate content and information throughout the tour.
	Engagement (1=Poor, 10=Excellent)
14	Engagement - Promptness to acknowledge questions and comments.
15	Respect for traditions, cultures, and needs of visitors and guests.
	Interactivity (1=Poor, 10=Excellent)
17	Interactivity - The capacity to connect content with questions and discussions during the tour.
18	The skill of the guide to create involvement among members of the tour group.
	Tour Guide (1=Strongly Disagree, 10=Strongly Agree)
20	Please rate your level of agreement with the following statements: The tour guide was responsive to the questions and needs arising during the tour.
21	The tour guide was enthusiastic about my participation at the U.S. Capitol.

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Sheet 6: Custom Questions (All)

Model Instance Name:

red & strike-through: DELETE

CVC Tour

underlined & italicized: RE-ORDER

MID:

MswBBENZcR8FIZ4o1RFBIw==

pink: ADDITION

blue + -->: REWORDING

Date:

#VALUE!

CVC Tour CUSTOM QUESTION LIST

QID

Skip Logic Label

Question Text

Answer Choices (limited to 50 characters)

Skip to

Type (select from list)

Single or Multi

Required Y/N

Special Instructions

CQ Label

Denise.Philips: This is internal, to assist me and the clients. You can ignore. CQ TYPE

CJI0053

Who guided you on your U.S. Capitol Tour?

A staff member of a Representative’s office

Drop down, select one

Single

Y

Skip Logic Group

Tour Type

TOUR

A staff member of a Senator’s office

A U.S. Capitol Visitor Guide

X

CJI0054

X

I was satisfied with the experience provided by my U.S. Capitol Visitor Guide.

Strongly agree

U

Drop down, select one

Single

Y

Skip Logic Group

TG Sat

TOUR

Agree

U

Disagree

T

Strongly disagree

T

Not sure

CJI0055

U

Please provide any additional comments about your tour experience.

Text area, no char limit

N

Skip Logic Group

OE TG Sat High

TOUR

CJI0056

T

Please tell us, in as much detail as possible, what you didn’t like so that we can attempt to correct any concerns you may have had.

Text area, no char limit

N

Skip Logic Group

OE TG Sat Low

TOUR

CJI0057

If you could make one suggestion to improve your tour experience, what would it be?

Text area, no char limit

N

OE_Improvement

TOUR

CJI0058

What was the approximate size of the entire group that was led by your tour guide?

Under 10

Radio button, one-up vertical

Single

Y

CVC Group - Size

TOUR

10-20

20-30

30-40

40-50

More than 50

CJI0059

Approximately how much time did you spend touring the U.S. Capitol?

Less than 15 minutes

Drop down, select one

Single

Y

Time Tour

TOUR

15 - 30 minutes

30 - 45 minutes

More than 45 minutes

CJI0073

Which of the following roles best describes you at the time of your visit?

Teacher / Professor

F

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Role

CVC

Student

Adult accompanying a child/children (ex: parent or guardian)

Congressional staff member

Tour organizer

Interested citizen (ex: tourist, family member, senior citizen, etc.)

International Visitor

Other (please specify)

D

CJI0074

F

What level of students do you teach?

Elementary School

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Teacher

CVC

Middle School

High School

College - Undergraduate

College - Post graduate

Prefer not to answer

CJI0075

D

What do you consider your role?

Single

Y

Skip Logic Group

CVC Other_Role

CVC

CJI0076

Did you arrive at the U.S. Capitol as part of a group?

Yes, I was part of a group (school, family, tourist group, etc.).

O, P

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Tour Group

CVC

No, I arrived alone (as an individual).

CJI0077

O

What was the approximate size of the entire group that you arrived to the Capitol with?

Under 10

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Group - Size

CVC

10-20

20-30

30-40

40-50

More than 50

CJI0078

P

Which of the following best describes the type of group you arrived at the Capitol with?

School group

T

Radio button, one-up vertical

Single

Y

Skip Logic Group

Tour Group - Type

CVC

Family

T

Senior citizen group

International visitor group

Other (please specify)

K

CJI0079

T

What were the age(s) of the children/students in your group? (Please select all that apply.)

Under 5 years old

Checkbox, two-up vertical

Multi

Y

Skip Logic Group

CVC Children's Ages

CVC

5-7 years old

8-10 years old

11-13 years old

14-17 years old

Over 17 years old

Prefer not to answer

8889

CJI0080

K

What other type of tour group were you part of?

Text area, no char limit

N

Skip Logic Group

CVC Other_Tour Group

CVC

CJI0081

What was the reason(s) you decided to visit the U.S. Capitol? (Please select all that apply.)

To learn about the history of the U.S. Capitol.

Checkbox, one-up vertical

Multi

Y

Skip Logic Group

CVC Primary Reason

CVC

To view the art and architecture of the U.S. Capitol building.

To learn about Congress and how it functions.

To visit the House or Senate Chambers in session.

To be able to ask questions to a knowledgeable person about the U.S. Capitol.

To simply be a tourist. I was curious and wanted to explore the U.S. Capitol.

I did not decide to visit the U.S. Capitol. It was part of my tour itinerary.

Other (please specify)

B

CJI0082

B

What was the other reason you decided to visit the Capitol?

Text area, no char limit

N

Skip Logic Group

CVC Other_Reason

CVC

CJI0085

Approximately how much time did you spend overall at the U.S. Capitol Visitor Center?

Less than 1 hour

Radio button, one-up vertical

Single

Y

CVC Time

CVC

1 - 1 1/2 hours

1 1/2 - 2 hours

2 - 3 hours

More than 3 hours

CJI0086

How often do you visit the U.S. Capitol?

This is my first time

Radio button, one-up vertical

Single

Y

CVC Frequency

CVC

Less than once a year

Once a year

Multiple times a year

CJI0089

At what time of day did you visit the U.S. Capitol? (Please select all that apply.)

Early morning

Checkbox, one-up vertical

Multi

Y

CVC Time of day

CVC

Late morning

Early Afternoon

Late Afternoon

CJI0090

Which day of the week did you visit the U.S. Capitol?

Monday

Radio button, one-up vertical

Single

Y

CVC Day

CVC

Tuesday

Wednesday

Thursday

Friday

Saturday

CJI0091

How recently did you visit the U.S. Capitol?

Within a week

Radio button, one-up vertical

Single

Y

CVC Timeframe

CVC

Within a month

Within the past 6 months

Within the past year

CJI0096

Did the U.S. Capitol Visitor Center staff (excluding tour guides - ex: workers at the coat check, entrance, etc.) meet or exceed your expectations?

Yes, the staff met or exceeded my expectations.

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Assistants

CVC

No, the staff did not meet my expectations.

M

CJI0097

M

Which of the following staff members at the U.S. Capitol Visitor Center fell below your expectations? (Please select all that apply.)

Coat Check

Checkbox, two-up vertical

Multi

Y

Skip Logic Group

CVC Assistants - Short

CVC

Entrance / Greeting Area

Exhibition Hall

Security

Theater

Other (Please specify)

N

CJI0098

N

What other staff members fell below your expectations?

Text area, no char limit

N

Skip Logic Group

CVC Other_Assistants

CVC

CJI0099

Would you like to provide additional comments about an interaction with a staff member? If so, please provide as much detail as possible here.

Text area, no char limit

N

CVC OE_Assistants

CVC

CJI0102

What is your overall satisfaction with the entire U.S. Capitol Visitor Center experience?

1=Very Dissatisfied

Radio button, scale, no don't know

Single

Y

CVC Overall Satisfaction

CVC

2

3

4

5

6

7

8

9

10=Very Satisfied

CJI0104

If you could make one suggestion to improve the entire U.S. Capitol Visitor Center experience, what would it be?

Text area, no char limit

N

CVC OE_Improvement

CVC

ACQhar0014870

Would you be willing to answer a few additional questions?

Yes

AA, BB, CC, DD, EE

Radio button, one-up vertical

Single

Y

Skip Logic Group

Additional Questions

TOUR

No

CJI0065

AA

Where do you currently live?

I live outside of the United States.

A

Drop down, select one

Single

Y

Skip Logic Group

CVC State

CVC

Alabama

Alaska

Arizona

Arkansas

California

Colorado

Connecticut

Delaware

District of Columbia

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

American Samoa

Federated States of Micronesia

Guam

Midway Islands

Northern Mariana Islands

Puerto Rico

Republic of Palau

Republic of the Marshall Islands

U.S. Virgin Islands

Prefer not to answer

CJI0066

A

What country do you live in?

Afghanistan

Drop down, select one

Single

Y

Skip Logic Group

CVC Country

CVC

Albania

Algeria

Andorra

Angola

Antigua and Barbuda

Argentina

Armenia

Australia

Austria

Azerbaijan

Bahamas, The

Bahrain

Bangladesh

Barbados

Belarus

Belgium

Belize

Benin

Bhutan

Bolivia

Bosnia and Herzegovina

Botswana

Brazil

Brunei

Bulgaria

Burkina Faso

Burma

Burundi

Cambodia

Cameroon

Canada

Cape Verde

Central African Republic

Chad

Chile

China

Colombia

Comoros

Congo (Brazzaville)

Congo (Kinshasa)

Costa Rica

Cote d'Ivoire

Croatia

Cuba

Cyprus

Czech Republic

Denmark

Djibouti

Dominica

Dominican Republic

East Timor

Ecuador

Egypt

El Salvador

Equatorial Guinea

Eritrea

Estonia

Ethiopia

Fiji

Finland

France

Gabon

Gambia, The

Georgia

Germany

Ghana

Greece

Grenada

Guatemala

Guinea

Guinea-Bissau

Guyana

Haiti

Holy See

Honduras

Hong Kong

Hungary

Iceland

India

Indonesia

Iran

Iraq

Ireland

Israel

Italy

Jamaica

Japan

Jordan

Kazakhstan

Kenya

Kiribati

Korea, North

Korea, South

Kosovo

Kuwait

Kyrgyzstan

Laos

Latvia

Lebanon

Lesotho

Liberia

Libya

Liechtenstein

Lithuania

Luxembourg

Macau

Macedonia

Madagascar

Malawi

Malaysia

Maldives

Mali

Malta

Marshall Islands

Mauritania

Mauritius

Mexico

Micronesia

Moldova

Monaco

Mongolia

Montenegro

Morocco

Mozambique

Namibia

Nauru

Nepal

Netherlands

Netherlands Antilles

New Zealand

Nicaragua

Niger

Nigeria

North Korea

Norway

Oman

Pakistan

Palau

Palestinian Territories

Panama

Papua New Guinea

Paraguay

Peru

Philippines

Poland

Portugal

Qatar

Romania

Russia

Rwanda

Saint Kitts and Nevis

Saint Lucia

Saint Vincent and the Grenadines

Samoa

San Marino

Sao Tome and Principe

Saudi Arabia

Senegal

Serbia

Seychelles

Sierra Leone

Singapore

Slovakia

Slovenia

Solomon Islands

Somalia

South Africa

South Korea

South Sudan

Spain

Sri Lanka

Sudan

Suriname

Swaziland

Sweden

Switzerland

Syria

Taiwan

Tajikistan

Tanzania

Thailand

Timor-Leste

Togo

Tonga

Trinidad and Tobago

Tunisia

Turkey

Turkmenistan

Tuvalu

Uganda

Ukraine

United Arab Emirates

United Kingdom

Uruguay

Uzbekistan

Vanuatu

Venezuela

Vietnam

Yemen

Zambia

Zimbabwe

Other (Please specify)

B

Prefer not to answer

CJI0067

B

Where do you live?

Text field, <100 char

N

Skip Logic Group

CVC Other_Country

CVC

CJI0068

BB

Which of the following best describes your race or ethnic background? (Please select all that apply.)

African American or Black

Checkbox, two-up vertical

Multi

Y

Skip Logic Group

CVC Race

CVC

American Indian or Alaska Native

Asian

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White or Caucasian (Not Hispanic or Latino)

Other (Please specify)

C

Prefer not to answer

8889

CJI0069

C

What is your race or ethnic background?

Text field, <100 char

N

Skip Logic Group

CVC Other_Race

CVC

CJI0070

CC

What is your gender?

Male

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Gender

CVC

Female

Prefer not to answer

CJI0071

DD

What is your age?

Under 18

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Age

CVC

18-24

25-34

35-44

45-54

55-64

65 or older

Prefer not to answer

CJI0072

EE

Which of the following best describes the highest level of education you have attained?

I have not graduated from high school.

Radio button, one-up vertical

Single

Y

Skip Logic Group

CVC Education

CVC

High school graduate

Some college, trade, technical or vocational training

College graduate

Post graduate degree

Prefer not to answer