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1.
Which devices do you use?
(Select all that apply)
Phone
Tablet
Desktop / Laptop
2.
What is your current employment status?
Employed full-time
Employed part-time
Self employed
Unemployed, but looking for a job
Unemployed, not looking / Long-term sick or disabled
Full-time parent / homemaker
Retired
Student / Pupil
3.
What is the COMBINED TOTAL MONTHLY INCOME (pre-tax) earned by all members of your household?
(Enter amount in USD)
USD
4.
What is the highest level of education you have achieved?
No formal education
Primary school
Secondary school / High school
Vocational / Technical training
Some college / University (not completed)
Bachelor's degree / Undergraduate
Master's degree / Postgraduate
Doctorate / PhD
Professional degree (e.g. MD, JD, MBA)
5.
What is your marital status?
Never Married (Single)
Domestic Partner (Living as a couple)
Married
Separated
Divorced
Widowed
6.
Are you currently expecting a baby?
Yes
No
Prefer not to answer
7.
Your country
8.
Which state/region do you live in?
10.
What are your reasons for becoming part of our community?
11.
Are you...?
Female
Male
Other
Prefer not to say
12.
Which of these items do you have at home?
(Select all that apply)
Ceiling Fan
LPG Stove
Two Wheeler
Television
Refrigerator
Washing Machine
Personal Computer/Laptop
Car/Jeep/Van
Air Conditioner
None of these
All of the above
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