Food and Nutrition Service (FNS) Form Cognitive Testing

Household Reporting Errors in the

National School Lunch Program (NSLP) and School Breakfast Program (SBP)

Interviewing Protocol Guide: Household Applicant; FNS-Developed Form

Revision History

Date	Version Number	Author	Changes Made
6/9/16	1	Graber	New document
6/21/16	1	Nelson	Track changes edits
6/27/16	2	Graber	Absorbed DVN comments
7/14/16	3	Graber	Comments from FNS, Argueta, expert review of form
7/26/16	4	Graber	Added in questions related to computer and internet use
7/29/16	5	Graber	Incorporated FNS comments

Household Reporting Errors in the

National School Lunch Program (NSLP) and School Breakfast Program (SBP)

Interviewing Protocol Guide: Household Applicant; FNS-Developed Form

PARTICIPANT ID #:

DATE:

/

/

INTERVIEWER NAME:

START TIME:

:

AM/PM (circle one)

Section 1. Introduction and Informed Consent

Hello, I’m [INTERVIEWER NAME]. I work for the Census Bureau. Thanks for agreeing to help me today.

PLACE THE CONSENT FORM IN FRONT OF THE RESPONDENT

Before we start, I would like you to read over the document in front of you. It explains a little bit about this interview and provides information about your rights as a participant. It also asks for your permission to have this session audio recorded. Please ask me any questions you have about this document. Once you have finished reading, please sign it.

PARTICIPANT READS AND SIGNS FORM

IF PARTICIPANT CONSENTED TO AUDIO TAPING, READ:

I will now turn on the audio recorder.

TURN ON AUDIO RECORDER

We are talking to families who applied for free or reduced price school meals. We want to know your thoughts about the process of applying and if there are ways to improve it next time.

I want to confirm that you or someone in your household filled out a form to receive meals at school that are free or cost less than the regular price. The form was probably filled out at the beginning of the school year and could have been for more than one child.

SHOW RESPONDENT A BLANK COPY OF THE APPLICATION

Did you or someone else complete this application?

IF YES, CONTINUE TO SECTION 2

IF NO, ASK

Did anyone in your household apply for school meals?

IF YES, ASK

Is [HE/SHE] available to talk with us too?

IF POSSIBLE, ARRANGE TO MEET WITH OTHER APPLICANT BUT CONTINUE WITH CURRENT RESPONDENT AND SKIP QUESTIONS THAT ARE NOT APPLICABLE.

Section 2. Structured Interview about Application Process
Today I’m going to ask you about the process of applying for free or reduced price school meals. But first, let me get some information about the children you applied for.
1. How many children did you request free or reduced price meals for?
2. Do you remember how many applications you filled out? [COLLECT NUMBER OF APPLICATIONS COMPLETED]
3. What grade(s) are [he/she/they] in?
[IF MORE THAN ONE CHILD]
4. Do they all go to the same school?
[IF MORE THAN ONE SCHOOL]
5. Are the schools all part of the same school district?
6. How long [has/have] the [child/children] attended [this/these] schools?
		Less than year
		Enter number of years
7. What is your relationship to [this/these] [child/children]? Are you [his/her/their]….?
[WRITE DOWN RESPONSE]
8. [Do/Does] [this/these] [child/children] live with you?
9. Please tell me the people who live in your household. You can just give me their first names, nicknames or initials? Let’s start with you.
[WRITE DOWN NAMES OF EVERYONE, INCLUDING RESPONDENT]
10. Next, give me the name(s) of the [child/children] you requested school meals for.
[NOTE THE CHILDREN NAMES LISTED ON THE ROSTER]
11. Does [NAME] live there full time?
[ASK FOR EACH PERSON LISTED][PROBE: SOMEONE MIGHT STAY WITH ANOTHER RELATIVE, PARENT OR SIGNIFICANT OTHER SOME OF THE TIME]
12. Has anyone recently moved in or out of your home? This could be an adult, child or infant.
[WRITE DOWN ADDITIONAL NAMES]
13. Are there any other children or babies you didn’t mention? They don’t have to be your children but are staying in your household.
[WRITE DOWN ADDITIONAL NAMES]
14. Do any other adults, either related to you or not, stay in your household sometimes? Maybe people who are temporarily away, like at school or in the hospital?
[WRITE DOWN ADDITIONAL NAMES]
Great. Now let’s talk about how you applied for school meals.
15. Tell me about how you learned about the free and reduced price meals program.
16. How did you get the application form?
[PROBE: WAS IT MAILED TO HH? GIVEN OUT AT AN IN-PERSON MEETING? SENT HOME FROM SCHOOL WITH child/student PAPERWORK? Which child? More than one child receive paperwork? DOWNLOAD FROM WEBSITE?]
17. Were you given other forms – not related to school meals – to fill out at the same time?
18. How much time did you have to complete and return the application form?
[PROBE: WAS ENOUGH TIME GIVEN, DID YOU FEEL RUSHED, COULD YOU HAVE GOTTEN ADDITIONAL INFORMATION IF YOU WOULD HAVE HAD MORE TIME TO COMPLETE IT?]
19. Did you feel like you had enough time to fill out the application? [PROBE IF NEEDED: WAS ENOUGH TIME GIVEN, DID YOU FEEL RUSHED, COULD YOU HAVE GOTTEN ADDITIONAL INFORMATION IF YOU WOULD HAVE HAD MORE TIME TO COMPLETE IT?]
20. Did the school offer any help to fill out the application? [IF YES →20a]
[WERE YOU GIVEN A TELEPHONE NUMBER TO CALL, COULD YOU MEET WITH SOMEONE IN PERSON?]
20a. Did you get any help from the school? [IF YES →20b]
20b. Can you tell me who helped you and how?
[WAS IT A TEACHER, SECRETARY, PTA MEMBER,…]
21. Did you have to check other documents or talk to others in order to fill out the form completely?
[IF YES, PROBE ON WHAT DOCUMENTS R NEEDED TO ACCESS OR WHO NEEDED TO SPEAK TO]
22. Do you remember how long it took you to complete the application? Include any time you might have spent looking for documents or talking with other people in your household to get the right information.
23. After you submitted the application did anyone from the school call or email you to ask questions or get more information? [IF YES →23a]
23a. What other information were you asked for?
24. Were you ever asked to provide any written documentation to go along with your application?
25. We are finding that many people are having problems when filling out this form. What types of problems did you experience when filling it out?
[PROBE FOR DETAILS]

Section 3. Step 1 of The Prototype Form

Now I’m going to ask you to look at, and fill out as best you can, a blank application form. It might look a bit different than the one you filled out for the school, but the questions should be the similar.

Please remember that my purpose for asking you these questions is to improve the application process for the next time. The help you are giving will not affect any school meals your children receive and by doing this you are not officially filling out a new form. None of these materials will be given to your [CHILD/CHILDREN]’s school.

[HAND THE RESPONDENT A BLANK COPY OF THE PROTOTYPE HOUSEHOLD APPLICATION FORM, INSTRUCTIONS, AND A SELECTION OF PENS AND PENCILS.

Here is a generic application form for free or reduced price school meals. It hasn’t been customized for any specific school or school district. I have also given you some instructions that go along with the application form.

NOTE IF THE RESPONDENT CHOOSES A PENCIL AFTER READING THE INSTRUCTIONS.

1. First take a look at the form itself. What are your initial impressions? We didn’t create the form so don’t feel like to have to hold back your opinion.

[PROBE: HOW LONG DO YOU THINK IT WILL TAKE SOMEONE TO COMPLETE THIS? IS IT EASY TO READ, IS THE SIZE OF THE LETTERS TO SMALL, DO YOU THINK IT WILL BE EASY OR DIFFICULT TO COMPLETE?

Next, I’m going to ask you to fill out the form and answer the questions exactly like if you were doing it for real. I am interested in your answers, but also want to know the process you go though in your mind when you answer the questions. I would like you to tell me everything that you are thinking and feeling as you go through the form and I will ask you questions along the way. Please remember that I am really interested in how these questions work for you, so there are no right or wrong answers.

You may not have all of the information you need to fill this out so I will be asking you to tell me what you would need to get and how you would go about collecting it.

I know this process might seem odd, so let’s do a practice question to give you an idea of what we are looking for. Remember to think aloud as you answer.

PRACTICE. How many windows are there in the house or apartment where you live?

Try to visualize the place where you live, and think about how many windows there are in that place. As you count up the windows, tell me what you are seeing and thinking about.

[PROBES:] How did you come up with your answer? I noticed that you hesitated. Tell me what you were thinking?

Great. Do you have any questions for me before we begin?

Ok. Please start filling out the form and say outloud what you are thinking. Please stop when you finish with Step 1.

[RECORD WHETHER RESPONDENT REFERENCED INSTRUCTION GUIDE]

2. Can you tell me in your own words what this instruction is asking you to do?

3. Can you tell me what “Household Member” means to you in this section?

[IF YOU WERE TO RE-PHRASE THIS INSTRUCTION, WHAT WOULD IT SAY?]

4. Step 1 defines a household member as “Anyone who is living with you and shares income and expenses, even if not related.” What do you think “shares income and expenses” means in this form?

5. Take a look at the column marked “Student.” Can you tell me what information is being asked for here?

6. Tell me what you are thinking when you see “Grade” and “Student” asked?

[HOW ARE THEY DIFFERENT FROM EACH OTHER? DO YOU THINK BOTH ARE NECESSARY? WHY OR WHY NOT?]

7. Please look at the section asking about foster children or kids that are homeless, migrant, or runway. Can you tell me in your own words what this is asking for?

[REFERENCE HOUSEHOLD ROSTER CREATED IN THE LAST SECTION AND PROBE]

8. You listed [#] children as living in your household. How easy or difficult was it to come up with this list?

[PROBES: DO ALL OF THESE CHILDREN LIVE IN YOUR HOUSEHOLD FULL TIME? IF NO, DID YOU QUESTION WHETHER OR NOT YOU SHOULD LIST THEM HERE?]

[IF ROSTER DOESN’T MATCH]

9. Earlier you told me there were [#] number of kids in your household. On the form you didn’t include [name, name, name]. Can you tell me about the difference between these lists?

[PROBE: WERE MISSING KIDS BABIES? ATTEND DIFFERENT SCHOOLS? DON’T LIVE THERE FULL TIME? NOT LEGAL GUARDIAN?]

[IF RESPONDENT’S CHILDREN DON’T ALL ATTEND THE SAME SCHOOL; SECTION 2, Q4]

10. You told me before that your children don’t all attend the same school. How easy or difficult was it for you to know which children to list on this form? Did where they go to school enter your mind when you were answering?

11. Why do you think the form asks you to list ALL of the household members who are infants, children or students?

[PROBE: EVEN CHILDREN THAT DON’T ATTEND SCHOOL]

12. Did you need to look at the instruction guide at any point when answering?

13. Do you think someone else in your household would have answered this section differently? [If yes, How so?}

14. Were any of the sentences or words used hard to understand or did anything confuse you about Step 1?

Section 4. Step 2 of The Prototype Form

Now please take a look at Step 2 on the form and complete that section.

[RECORD WHETHER RESPONDENT REFERENCED INSTRUCTION GUIDE]

1. In your own words, what information do you think this section is asking for?

2. Look at this section for “Case Number.” In your own words can you tell me what is being asked for?

[IF RESPONDENT REPORTED PARTICIPATING IN ASSISTANCE PROGRAM]

3. Who in your household applied for that assistance?

[WAS IT EASY OR DIFFICULT TO ANSWER THIS QUESTION? WOULD SOMEONE ELSE IN YOUR HOUSEHOLD ANSWER IT DIFFERENTLY?

[IF PRIMARY RECIPIENT NOT LISTED ON THE HOUSEHOLD ROSTER]

4. I don’t see [NAME] listed on your roster. Why did you not think to include [HIM/HER]?

[IF RESPONDENT REPORTED PARTICIPATING IN ASSISTANCE PROGRAM]

5. Do you know this case number from memory or would you have to go get this information?

[IF NEEDED TO COLLECT INFORMATION]

6. How would you get this information? [PROBE: Would you have to check paperwork? Ask someone else in your household? Make calls to someone?, etc. What if the primary recipient was not related? Would it be difficult?]

[IF RESPONDENT DID NOT REPORT PARTICIPATING IN ASSISTANCE PROGRAM]

7. Let’s look at the list of people in your household you initially gave me. Does anyone receive any assistance from any state or local agencies? Maybe for food assistance or something else?

[CAN YOU GIVE ME SOME EXAMPLES OF THE PROGRAMS LISTED IN STEP 2?]

8. Did you need to look at the instruction guide at any point when answering? [IF YES →8a]

8a. What information were you looking for? Were you able to find it? Was it hard to find? Did you still have questions that weren’t answered even after reading the guidance?

9. Was there anything else about Step 2 that you want to talk about?

Section 5. Step 3 of The Prototype Form

Great. Let’s move onto the next step. Remember to think out loud as you are completing these questions. I know you might not be able to answer all of the questions without looking for paperwork or talking to others and that is ok. Just tell me what you would do to get the information.

[RECORD WHETHER RESPONDENT REFERENCED INSTRUCTION GUIDE OR INSTRUCTIONS ON THE BACK OF THE FORM; WERE ANY INSTRUCTIONS SKIPPED?]

[RECORD IF RESPONDENT SPENT A LOT OF TIME ON SPECIFIC ITEMS]

SECTION A

[AFTER RESPONDENT COMPLETES SECTION A]

1. Let’s go line by line through this step. Section A asks about child income. What do you think is considered “child income?”

2. How easy or difficult was it to answer this question?

3. What instructions did you look at when filling this out?

4. Looking at the options under “How often?,” could you tell me what you think about these answer categories. What do they mean? Are any missing? Do you think some should be removed?

[IF ANY CHILD INCOME WAS REPORTED IN STEP 3, SECTION A, ASK]

5. Did you have a hard time knowing what category to pick?

[IF ANY CHILD INCOME WAS REPORTED IN STEP 3, SECTION A, ASK]

6. Let’s talk about each child in your household that earns income. Please tell me the first name of each child and what type of income he or she receives.

[IF ANY CHILD INCOME WAS REPORTED]

7. Is this information you could find easily, or would you have to talk to others or collect documents to find this out?

[IF CHILDREN ARE INCLUDED THAT AREN’T IN THE HH ROSTER OR SECTION A, ASK]

8. I don’t see [NAME] listed on your roster or in Section A. How did you decide whether or not to include [HIM/HER]?

[FOR EACH CHILD LISTED IN QUESTION 6 ASK]

9a. How often does [NAME] receive [INCOME TYPE]?

9b. How much does [he/she] get every [TIME PERIOD]?

9c. Is the amount the same each [TIME PERIOD], or does it vary ? [IF VARIES →9c1]

9c1. Since the amount may be different each [TIME PERIOD], tell me how you came up with [NAME’S] total.

9d. How easy or difficult was it to come up with a total for [NAME]?

REPEAT QUESTION 9 SERIES FOR ALL CHILDREN LISTED IN QUESTION 6

[IF ANY CHILD INCOME WAS REPORTED]

10. Question A asks you to total up all of the income for all children in your household. People find this hard to do since not all children receive income on the same schedule or don’t receive the same amount each time.

Please tell me how you decided what to report. [HOW DID YOU SELECT A TIME PERIOD FOR ALL CHILDREN?]

[IF ANY CHILD INCOME WAS REPORTED]

11. Would this question have been easier, more difficult or about the same to complete if each child was listed out separately?

[IF ANY CHILD INCOME WAS REPORTED THAT WAS FROM WORK AND COULD BE TAXED]

12. When you were adding up the total child income were you thinking about “take home” pay or pay before taxes were removed?

13. How did you calculate this answer?

14. Would others in your household answer this the same way?

[IF ANY CHILD INCOME WAS REPORTED]

15. Would anyone in your household, either the child with income or another adult, not want to give you this information?

Now I want to go back and look at the household roster we created when we first started.

[COMPARE THE NAMES LISTED AGAINST WHAT WAS ENTERED ON THE SEPARATE ROSTER; FOR EACH CHILD ON ROSTER NOT LISTED IN STEP 1 OR CONSIDERED FOR STEP 3, SECTION A]

16. Does [NAME] receive any income? [IF YES →16a]

16a. Tell me how do decided whether or not to include [him/her] in question A?

SECTION B

Thank you. Now let’s look at Section B of this Step. Please complete this section.

17. Can you give me some examples of types of income?

18. Can you tell me in your own words what they are asking for in section B?

19. How did you decide who to list here?

20. Looking at the options under “How often,?” tell me what you think about these. Are any categories missing? Do any not make sense?

21. You listed [NAME] as earning [$] each [TIME PERIOD] from work. Is this income from one job or more than one? [PROBE IF PERSON HAS OTHER JOBS, EITHER FULL OR PART TIME, STEADY OR OCCASIONAL]

[IF {NAME} HAS MORE THAN ONE JOB]

22. Do [both/all] of [NAME]’s jobs pay on the same schedule?

23. How easy or difficult was it to answer this question?

24. Does [NAME] receive [any/any other] type of income from a previous marriage or relationship [SUCH AS CHILD SUPPORT OR ALIMONY]?

25. Can you give me some examples of income like child support or alimony? What would you include here? Only what is formally provided [THROUGH COURTS] or other money or help given by a parent? [ASK ONLY FOR THE FIRST PERSON LISTED]

26. Can you give me some examples of public assistance programs that you consider to be “sources of income?” [ASK ONLY FOR THE FIRST PERSON LISTED]

[LOOK AT WHAT RESPONDENT SAID IN STEP 2 ABOUT PUBLIC ASSISTANCE]

27. Does [NAME] get any income from assistance programs, such as unemployment benefits, workers’ compensation, Supplemental Security Income (SSI), veterans’ benefits or some other type of cash assistance?

28. Is [NAME] collecting any disability benefits, either short or long term?

29. Does [NAME] receive any retirement income, from the government, private pensions, or personal retirement investments?

30. Is [NAME] in the military? [IF YES →30a]

30a. Can you give me some examples of military pay or benefits?

[PROBE: THIS COULD BE BASE PAY, HOUSING ALLOWANCE, ETC.]

31. Does [NAME] have any other types of income that we’ve forgotten? This could be income from rental properties, inheritances, investments, or other regular cash payments or gifts from someone who doesn’t live in your household.

32. How certain or uncertain are you of your answers to this section for [NAME]?

REPEAT QUESTIONS 21-32 FOR EACH ADULT LISTED IN SECTION B

[SEE RESPONSE TO QUESTION 22]

33. Thinking about the various types of income people in your household receive, not just “earnings from work”, do any adults in your household get paid on some other schedule? Maybe daily? Or every few months? Or on a schedule that changes? Who is that? [IF YES →33a]

33a. Please tell me how you calculated [NAME’S] income? [DID RESPONDENT TAKE ANNUAL SALARY AND DIVIDE BY 12? SOMETHING ELSE?]

34. When you were listing out the “earnings from work” for the adults, were you thinking about “take home” pay or pay before taxes were taken out?

[COMPARE THE NAMES LISTED AGAINST WHAT WAS ENTERED ON THE ROSTER DEVELOPED AT THE BEGINNING OF THE INTERVIEW; IF NAMES WERE LISTED ON ROSTER BUT NOT IN SECTION B, ASK FOR EACH]

35. Earlier you mentioned that [NAME] lived in your household. How did you decide who to include or not in Section B?

36. Do you think others in your household would have given the same list as you did?

37. Sometimes people don’t know how much other household members make. Of the people listed here, who would you be unsure of their income? How would you get this information?

[IF RESPONDENT WOULD NEED TO ASK OTHERS INDIVIDUALLY →37a – 37d1]

37a. How long do you think it would take to collect this income information from everyone in your household?

37b. Thinking just about “earnings from work” would some adults in your household not want to give you this information? [IF YES →37b1]

37b1. Why do you think that is?

37c. What about “public assistance, child support or alimony?” Would others not want to tell you those amounts? [IF YES →37c1]

37c1. Why do you think that is?

37d. And what about “pensions, retirement income, or anything else?” [IF YES →37d1]

37d1. Why do you think that is?

Now let’s talk about this section more generally, and not about the people in your household.

38. Sometimes people don’t want to be listed as living in a particular place. This could be due to housing policies or some other personal reason. If someone in your household didn’t want others to know that they were living there, what would you do when filling out the form? Would it make a difference if you didn’t have to provide a full name but maybe only initials or a nickname?

[PROBE: WOULD YOU LEAVE THEM OFF? INCLUDE THEIR INCOME ONLY? NOT GIVE A FULL NAME, ETC].

39. Looking just at Step 3, section B, what problems, if any, did you have when you completed this section?

40. Which questions were unclear or confusing?

41. Which instructions did you look at when completing this section?

42. Let’s take a look at the instruction sheet. What information here do you find helpful or confusing?

43. How could these instructions be improved or made clearer?

Great. Now let’s go back to your form and look at the box labeled “Total Household Members.”

[CHECK THE RESPONSE ENTERED FOR ‘TOTAL HOUSEHOLD MEMBERS’ AND COMPARE IT TO THE SUME OF STEP 1 (CHILDREN) AND STEP 3 (ADULTS)]

44. How did you come up with your answer?

[IF NUMBER IS NOT CORRECT ASK]

45. Which household members did you include in your count?

[IF CHILDREN LISTED IN STEP 1 WERE NOT INCLUDED, ASK]

46. Tell me how you decided whether or not to include [NAMES]? [PROBE: Child didn’t earn income? Age of child? Etc.]

[IF HH TOTAL IS NOT CORRECT, ASK]

47. Let’s take a look at the instruction sheet. Would anything written here have helped you to fill out this section?

48. How could this instruction been made clearer for you?

49. Now look at the item asking for the last 4 digits of a Social Security Number . Tell me what you think is meant by “primary wage earner?” Who would that person be in your household?

50. [IF NOT RESPONDENT] Is [NAME]’s Social Security Number something you could easily get or would you have to ask someone for it?

[IF NEEDED TO GET INFORMATION →50a]

50a. Would you have a hard time getting this? Would someone not want to give it to you?

51. What are your overall thoughts about Step 3 of the form? What parts were easy to complete? Which parts were confusing or difficult? Which did you not have the information you needed to be able to answer?

52. Do you have any other thoughts about Step 3 you would like to talk about? Things that confused you or ways to improve the form?

Section 6. Step 4 of The Prototype Form

Great. Let’s move on to Step 4. Please complete this section.

[RECORD WHETHER RESPONDENT REFERENCED INSTRUCTION GUIDE]

1. Who do you think should sign the form?

[IF NOT ALL BOXES WERE COMPLETE]

2. Tell me why you didn’t fill out [SPECIFIC ITEM/S]?

[IF RESPONDENT GAVE SOMEONE ELSE’S NAME, ASK]

3. I see you listed [NAME] in this section. Can you tell me why you didn’t list your own name?

[HOW DIFFICULT WAS IT FOR YOU TO DECIDE WHOSE NAME TO ENTER?]

4. Look at the box labeled “Daytime Phone and Email.” Could you tell me in your own words what is being asked for?

Section 7. General and Debriefing Questions

Thank you. I now just have some general questions about the form.

1. Tell me how you think decisions are made about who receives free or reduced price meals. What determines who is approved?

[IF RESPONDENT DID NOT KNOW →1a]

1a. The school meals program determines if a child is eligible based on the number of people living in the child’s household and the total income earned by the people living there.

It doesn’t matter the age or relationship of the people in the household, or whether children go to the same or different schools. What matters is the total number of people living there and how much income the household receives. Then, if the household meets a certain income threshold, the child is approved for free or reduced price meals.

Would knowing that have changed how you thought about the questions on the form?

[IF YES →1b]

1b. How so?

2. Overall, would you say the questions on the form were easy or difficult to respond to? For what reason(s)?

3. Do you think some people might find any of these questions sensitive? Which one(s)?

4. We are asking these questions to try to make it easier for people to apply. Do you have any other thoughts about how to help people report everyone who lives in their household?

5. …. to help to make sure all household income is reported?

6. Do you have anything else you would like to tell us that you haven’t had a chance to mention yet?

Section 8. Respondent Demographics
Thank you so much. We are just about finished. Before we end, we would like to get some additional information about you.
1. In what month and year were you born?
MONTH				YEAR
2. What is the highest grade or year of school you have completed?
		Less than high school
		Completed high school
		Some college or Associates degree (AA/AS)
		Bachelor’s Degree (BA/BS)
		Post-Bachelor’s Degree (MA/MS/PhD/JD etc.)
3. Are you male or female?
		Male
		Female
4. Are you Hispanic, Latino or of Spanish origin?
		Yes
		No
5. 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
6. What is the primary language spoken in your home?
		English
		Spanish
		Some other language			(please enter other language)
7. In what country were you born?
8. How long have you lived at your current address?
		Less than one year
		Enter number of years
9. Do you live in a house, an apartment, or mobile home?
10. Is your home owned by you or someone else in the household free and clear (without a mortgage or loan), rented, or occupied without payment of rent?
11. Do you, or any other member of your household own or use the following types of computer?
[CHECK ALL THAT APPLY]
		Desktop or laptop
		Smartphone
		Tablet or other portable wireless device
		Some other type of computer
12. Do you, or any other member of your household have access to the internet?
[IF YES →13]
13. What kind of internet access do you have?
[CHECK ALL THAT APPLY]
		Cellular data plan for a smartphone or other mobile device
		Broadband or high speed internet service such as cable, fiber optic or DSL service installed in your household
		Satellite internet service installed in your household
		Dial-up internet service installed in your household
		Some other service
14. Do YOU use a cellular phone or smartphone?
[IF YES →15]
15. When you use your cellular phone or smartphone, do you…
[CHECK ALL THAT APPLY]
		Send and receive text messages
		Browse the web
		E-mail
16. How often do you use or visit the Internet for paying bills, shopping or other financial transactions?
		Very often
		Often
		Sometimes
		Rarely
		Never
17. How often do you use or visit the Internet for filling out forms, applications or surveys?
		Very often
		Often
		Sometimes
		Rarely
		Never
18. Do you prefer to fill out forms and applications, like the school meals program application, on the internet or on a paper form?
19. Can you tell me your reasons for preferring [RESPONSE TO Q17]?

Section 9. Closeout and Respondent Payment
I want to thank you very much for your participation. I will now give you $40 and ask you to sign a receipt form verifying that you received the money.
TURN OFF THE TAPE RECORDER. HAND THE CASH INCENTIVE TO THE PARTICIPANT.
END TIME:		:		AM/PM (circle one)

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