ID #
2016 Census Test
Please answer the following questions based on what you can recall about the 2016 Census Test. Please do NOT include phone calls or messages from the Census Bureau about this focus group.
Do you remember being contacted by the Census Bureau about the 2016 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
How were you instructed to respond to the 2016 Census Test? Select all that apply.
Through email
Online form
By phone
Mail-in paper form
In person
Did you respond to the 2016 Census Test?
Yes
No
Don’t know
Did you respond to the 2010 Census?
Yes
No
Don’t know
****There are more questions on the back****
In what year were you born? __________________ year
Are you male or female?
Male
Female
Are you of Hispanic, Latino, or Spanish origin?
Yes
No
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
In what city and country were you born? ______________________________
How long have you lived in the U.S.? _______months or __________ years.
What is the highest level of education you have achieved?
Primary school (grade school)
Secondary school, less than HS
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)
Do you prefer to complete forms and questionnaires in Ingles or in Spanish?
Ingles
Spanish
Both/no preference
Do you sometimes read in English?
Yes
No
Please give me a couple of examples of things you read in English:
___________________________________________________________________________
If you did not respond to the 2016 Census Test, please write why you did not respond in the space below.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Aleia Y C Fobia |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |