1. Please specify your gender. Male Female
2. In which age-group do you fall? 16 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 and above.
3. In what industry do you work? Manufacturing Leisure and Hospitality Education Healthcare Financial/Professional Social Service Government Trade Technology Agriculture Real Estate/Construction Transportation Other
4. Please mention the name of your city and state.
5. In what type of an accommodation do you currently live? One bedroom accommodation Two bedroom accommodation Three bedroom accommodation Four bedroom accommodation Five bedroom accommodation Other
6. What is the average monthly rent you pay for housing/accommodation? $500 - $1000 $1100 - $1500 $1600 - $2000 $2100 - $2500 $2600 - $3000 $3100 - $3500 Other
7. What is the average monthly cost you pay for utilities such as gas,electricity,water,cable and internet? Less than $100 $100 - $150 $150 - $200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $500 More than $500
8. How much do you spend per month on transportation which includes gasoline, maintenance, repairs and auto insurance? Less than $200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $500 More than $500
9. What is the health insurance premium you pay for a single person per month? Less than $100 $100 - $150 $150 - $200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $450 $450 - $500 More than $500
10. How much do you spend per month on groceries? Less than 200 $200 - $250 $250 - $300 $300 - $350 $350 - $400 $400 - $450 $450 - $500 More than $500
11. How much do you contribute per month toward your retirement plan(s) and social security?
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