1.What is your gender?
Female
Male
2.What is your citizenship status in the U.S.?
US Citizen
US National
Permanent Resident
Legal Alien
Other
3.What is your current marital status?
Divorced
Married
Re-Married
Single
Widowed
 		4.Are you a parent or primary caregiver?
Yes
No
5.Do you have debt in any of the following areas?(check all that apply)
Education Loans
Housing Debt/Mortgage
Credit Card Debt
6.How would you categorize your health insurance?
Underinsured
Uninsured
Fully Insured
7.Do you have a U.S. Drivers license or ID?
Yes
No

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