Maricopa County - Focus Groups

ID #

Focus Group Worksheet

2015 Census Test

Please answer the following questions based on what you can recall about the 2015 Census Test. Please do NOT include phone calls or messages from the Census Bureau about this focus group.

1. Do you remember being contacted by the Census Bureau about the 2015 Census Test?

• Yes

• I saw advertisements

• I received an email

• I received a postcard

• I received a letter

• I received a phone call

• I received a text message

• Someone came to my home

• No – Skip to question #3

2. How were you instructed to respond to the 2015 Census Test? Select all that apply.

• Through email

• Online form

• By phone

• Mail-in paper form

• In person

3. Did you respond to the 2015 Census Test?

• Yes

• No

• Don’t know

4. Did you respond to the 2010 Census?

• Yes

• No

• Don’t know

5. If you did not respond to the 2015 Census Test when you were first contacted about it, please write why you did not respond in the space below.

6. In what year were you born? __________________ year

7. What is the highest level of education you have achieved?    

• Primary school (grade school)

• Secondary school, less than High school

• High school or equivalent (GED) 

• Some college, no degree  

• Currently a college student

• Associate’s degree 

• Bachelor’s degree or higher (master’s, PhD, other)

8. Are you male or female?

• Male

• Female

9. Are you of Hispanic, Latino, or Spanish origin?

• Yes

• No

10. What is your race? Choose one or more races.

• White

• Black or African American

• American Indian or Alaska Native

• Asian

• Native Hawaiian or Other Pacific Islander

• Some other race

11. In what city and country were you born? ______________________________

12. How long have you lived in the U.S.? _______months or  __________ years.

Hispanic groups only:

13. Do you prefer to complete forms and questionnaires in Ingles or in Spanish?

• Ingles  

• Spanish  

• Both/no preference

14. Do you sometimes read in English?

• Yes      

• No

15. Please give me a couple of examples of things you read in English:

     ___________________________________________________________________________

4 OMB Control Number: 0607-0981 Expires: 3/31/2016