Visual Perception of Color Quality of Light Sources

Project Title: Visual perception of color quality of light sources

Demographic Questionnaire for vision experiment:

Participant number _____________________

This information is kept confidential and linked to the experiment results identified only by the participant number and will never be linked to your name.

Information below will be used only for the purpose of correlating the experimental results to these demographics.

Gender ____M / F____

Age ________ years

Ethnicity (check one)

[ ] Hispanic or Latino

[ ] Not Hispanic or Latino

Race (check all that apply)

[ ] American Indian or Alaska Native

[ ] Asian

[ ] Black or African American

[ ] Native Hawaiian or Other Pacific Islander

[ ] White

This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. Public reporting burden for this collection is estimated to be 1 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any aspect of this collection of information, including suggestions for reducing this burden, to the National Institute of Standards and Technology, Attn: Dr. Yoshi Ohno, 301-975-2321 or email him at [email protected] .

OMB Control No. 0693-0043

Expiration Date: 12/31/2018

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NIST IRB Approval ________________ NIST IRB Case #___________ 2