Form Attachment 5 Attachment 5 Web-based information update form

Attachment 5-- Round 17 Web-based Information Update Form

Thank you for taking the time to try out a potential new data collection tool. By completing this survey, you will help us to develop alternative ways for you to participate in the NLSY97 in the future. The survey will take less than 10 minutes of your time. On behalf of everyone here at NORC and BLS, we thank you for your continued support and dedication to the NLSY97.

This study is sponsored by the U.S. Department of Labor, Bureau of Labor Statistics. This study is voluntary, and you may decline to answer specific questions. You also may end the interview at any point. Personal identifiers such as name and address will be held in confidence and will not be released to the public without your consent. All personnel associated with this study have signed a legal document in which they pledge to protect the confidentiality of the information that survey participants provide.

Q0_TechUsed Which of the following are you using to complete this questionnaire?

1. Smart phone (such as iPhone, Android, Blackberry, etc.)

2. Tablet or iPad

3. Laptop or Desktop computer

4. Something else

1. Did you do any work for pay last week, even for one hour?

1 Yes (go to 2)

2 No (ask 1a)

1a. Were you on layoff from a job last week?

1 Yes (skip to 1c)

2 No

1b. Were you temporarily absent from a job or business last week?

1 Yes, on vacation, temporary illness, maternity leave, other family/personal reasons, bad weather, etc. (go to 2)

2 No

1c. During the last 4 weeks, have you been actively looking for work?

1Yes

2 No

1d. Last week, could you have started a job if offered one, or returned to work if recalled?

1 Yes, could have gone to work

2 No, because of own temporary illness

3 No, for all other reasons (in school, etc.)

2. How many different jobs did you have during the calendar year 2014? Please include all jobs you may have had, including regular jobs, self-employment, work in the military, or work for a family business whether or not you get paid.

__________ NUMBER OF JOBS IN 2014

2a. [if jobs > 0] During calendar year 2014, about how many weeks did you work at (this job/these jobs)?

____________ WEEKS WORKED IN 2014

2b. Please think about the job that you held for the most weeks during 2014. What kind of work did you do on that job? That is, what was your occupation? (For example: plumber, typist, farmer..)

__________________________________ JOB TITLE AT JOB HELD MOST WEEKS IN 2014

3. [YINC-550] How much did you and your spouse or partner (if you had one) have in total income from all sources in the calendar year 2014? Considering your earnings, (and if you had a spouse or partner, that person’s earnings,) and all other income, which of these categories would you say best describes your family’s total income from all sources in the calendar year 2014:

1   A. $0 - $5,000

2   B. $5,001 - $10,000

3   C. $10,001 - $25,000

4   D. $25,001 - $50,000

5   E. $50,001 - $100,000

6   F. $100,001 - $250,000

7   G. More than $250,000

4. [YSCH-3113] What is the highest educational degree you have ever received?

                1      None (skip to 5)

                2      GED    

                3      High  school  diploma  (Regular  12  year  program)

                4      Associate/Junior  college  (AA)

                5      Bachelor's  degree  (BA,  BS)

                6      Master's  degree  (MA,  MS)

                7      PhD

                8      Professional  degree  (DDS,  JD,  MD)

4a. (If Q4 ne 1 or DK/Refused) In what month and year did you receive that degree?

_______________ Month _____________ Year

5. [CV_HH_SIZE] Including yourself, how many people currently live in your household?

_______________ HH SIZE

6. [CV_BIO_CHILD_HH] How many of these people are your own biological children?

_______________ BIOLOGICAL CHILDREN LIVING IN CURRENT HH

7. [MAR-650] What is your current legal marital status?

		0      Never-married
		1      Married
		2      Separated
		3      Divorced
		4      Widowed
	8. In what month and year did you last move from one city or county to another?  _______________ Month _____________ Year 1 NEVER MOVED FROM ONE CITY/COUNTY TO ANOTHER (SKIP TO q9) What city or county did you move from and what where did you move to? From: City/County_________________ State _________ To: City/County_________________ State _________

9. Of all the telephone calls that you or your family receives, are …

1 All calls received on cell phones

2 Almost all calls received on cell phones

3 Some received on cell phones and some on regular home phones

4 Very few received on cell phones

5 None received on cell phones

9a. Do you use any of the following devices?

1. Smart phone Y N

2. Tablet or I-Pad Y N

3. Laptop or desktop with Internet access Y N

4. Cell-phone Y N

	10. Do you recall receiving any regular or express mail from NORC in the past year? 1 Yes 2 No (skip to q12) 10a. Did you open the envelope or mailing that you received from us? 1 Yes 2 No 3 I don’t remember 11. Do you recall receiving an e-mail from NORC in the past year? 1 Yes 2 No (skip to q12) 11a. Did you open the e-mail that you received from us? 1 Yes 2 No 3 I don’t remember 12. How would you like to complete your next NLSY97 interview? 1 In-person 2 By telephone

13a. How do you prefer to hear from the NLSY97 in the future?

First choice: 1 By mail  please provide your street address Address 1________________________

Address 2

City __________ State ___ ZIP _______

2 By text  Please provide a cell phone number where we may text you

3 By e-mail  What e-mail address should we use for you? ___________________________

4 By telephone  What phone number should we use to call you?

13b. Second choice: 1 By mail  please provide your street address Address1________________________

Address 2

City __________ State ___ ZIP _______

2 By text  Please provide a cell phone number where we may text you

3 By e-mail  What e-mail address should we use for you? ___________________________

4 By telephone  What phone number should we use to call you?

13c. Third choice: 1 By mail  please provide your street address Address 1________________________

Address 2

City __________ State ___ ZIP _______

2 By text  Please provide a cell phone number where we may text you

3 By e-mail  What e-mail address should we use for you? ___________________________

4 By telephone  What phone number should we use to call you?

14. [IF BY MAIL NOT SELECTED ABOVE, COLLECT CURRENT ADDRESS]

What is your current address?

Address 1

Address 2

City State ZIP

15. Please confirm the spelling of your name:

First _______________________________ Middle ____________________ Last ________________

16. Would you say that you think the NLSY97 is…

1. very valuable for understanding the lives of people like you

2. somewhat valuable for understanding the lives of people like you

3. not very valuable for understanding the lives of people like you

4 not valuable at all for understanding the lives of people like you

Thank you for taking the time to answer these questions.