600x600.htm
AM 1 19/ AM
Time started PM 2 Time finished PM Total minutes 20/21
15/16/17/18
I~m from The Roper organization and we're conducting a survey about things that are happening today.
1. considering both the availability and cost of things today, as well as your present financial circumstances, do you think
now is a good time to buy things you want and need, or a good time to wait, or is it someplace in between?
Now is a good time to buy ... 1 Someplace in between .. .3 22/
Now is a good time to wait .2 Don~t know Y
2. Do you feel things in this country are generally going in the right direction today, or do you feel that things have pretty
seriously gotten off on the wrong track?
Right direction 1 Don~t know Y 23/
Wrong track 2
3. What is your opinion of most Federal Government departments and agencies? There may be exceptions, of course, but
would you say your opinion of most Federal Departments and agencies is highly favorable, or moderately favorable, or not
too favorable, or rather Uflfavorable?
Highly favorable 1 24/
Moderately favorable 2
Not too favorable 3
Rather ~favorable 4
Donet know Y
a. F.T.C. (Federal Trade Commission) 1 2 3 4 Y 25/
b. F.B.I. (Federal Bureau of Investigation) .1 2 3 4 Y 26/
c. O.S.H.A. (Occupational Safety and Health
Administration) 1 2 3 4 Y 27/
d. F.C.C. (Federal Communications
Commission) 1 2 3 4 Y 28/
e. N.A.S.A. (National Aeronautic and Space
Administration) 1 2 3 4 Y 29/
f. B.A.T.F. (Bureau of Alcohol, Tobacco,
and Firearms) 1 2 3 4 Y 30/
g. I.R.S. (Internal Revenue Service) 1 2 3 4 Y 31/
h. F.A.A. (Federal Aviation Administration) .1 2 3 4 Y 32/
5. Here is a list of some social problems. (HAND RESPONDENT CARD) For each one, please tell me if you think it
affects vou more, less, or the same as the average person in this country?
ABOUT'
~RE L~~S THESAM~ ~
a. Violent crime 1 2 3 Y 33/
b. Pollution 1 2 3 Y 34/
c. Economic hardship 1 2 3 Y 35/
d. Police brutality 1 2 3 Y 36/
e. High taxes 1 2 3 Y 37/
f. Discrimination 1 2 3 Y 38/
6. There has been talk about whether some problems in society have more of an impact or less of an impact on racial and
ethnic minorities than they have on other people. (USING SAME CARD) For each one, please tell me if you think
it affects racial and ethnic minorities more, less, or about the same as other people?
ABOUT'
1~RE L~S THE~E ~
a. Violent crime 1 2 3 Y 39/
b. Pollution 1 2 3 y 40/
c. Economic hardship 1 2 3 y 41/
d. Police brutality 1 2 3 y 42/
-~ -.. - 1 v 43/'
f. Assault 6
g. Racketeering, extortion 7
h. Drugs 8
i. Prostitution 9
j. speculationandswindling 0
k. Other 1 46/
Noneof theabove (vol.) 2
Don~tknow Y
8. Of course, the problems we face in 9. What about drunk driving? (HAND
our society often have many differ- RESPONDENT CARD) Using this card,
ent causes. I am going to ask you which three or ifour things do you
about some different problems in think are the inain causes of people
society and for each one I want you becoming drunk drivers?
to tell me what you think are the DRUNK
ma~or causes of each problem. DRIVING
First, violent crime. (HAND RESPON
DENT CARD) Using this card, which a. Livinginpoverty 1
49/
three or ifour things do you think b. Parents not teaching
are the main causes of people com
mitting violent crimes? right from wrong 2
VIOLENT c. Being abused as a child 3
CRIME d. Drug abuse 4
a. Livinginpoverty 1 47/ e. WhatpeopleseeinTVprograms 5
b. Parents not teaching f. A lack of morals 6
right from wrong 2 g. A lack of education 7
c. Being abused as a child 3 h. A person not seeing any harm in it .8
d. Drugabuse 4 i. Apersonbeingirresponsible 9
e. What people see in TV programs 5
j. Influenceof friends 0
f. A lack of morals 6
g. A lack of education 7 k. Being unable to control drinking
h. A person not seeing any harm in it .8 because alcoholism is a
i. A person being irresponsible 9 disease x
1 Influenceof friends 0 1. Whatpeopleseeinmovies Y
k. Alcohol abuse m. What people see in advertising 1 50/
1. What people see in movies n. Bartenders not being responsible.... 2 m. The
advertising and marketing
0. Lowchanceof beingpunished 3
of toy guns, etc 1 48/
n. Guns being too easy to get 2 p. Friends and family not looking
0. Low chance of being punished 3 out for each other .....
.4
p, Seeingpornography 4 None of these 5
Noneofthese 5 /1 Don~tknow Y
Donetknow Y
UnELY WHAT REAL DIS- L
~ SATIS- ~ SATIS- ~ BoILI~~ ~DT LI~ PIASED FlED ~ FIED
AM~~Y ~ ~
a. The way things are going
for you personally these
days 1 2 3 4 S 6 7 Y 51/
b. The way things are going
for the country
generally 1 2 3 4 5 6 7 Y 52/
c. How President Clinton
is dealing with the
econaty 1 2 3 4 5 6 7 Y 53/
d. How Congress is dealing
with the econorr~~ 1 2 3 4 5 6 7 Y 54/
e. How your state government is dealing with the
state~seconaty 1 2 3 4 5 6 7 Y 55/
f. Howsecureyourjobis ....l 2 3 4 5 6 7 Y 56/
g. Yourhealthcarecosts .. .1 2 3 4 S 6 7 Y 57/
h. Theamountofyour
housenoldinc~ne 1 2 3 4 5 6 7 Y 58/
i. Therateofinflation 1 2 3 4 5 6 7 Y 59/
j. The amount of taxes
youpay 1 2 3 4 5 6 7 Y 60
k. The level of interest
rates 1 2 3 4 S 6 7 Y 611
1. The cost and value of
yourhousing 1 2 3 4 S 6 7 Y 62/
m. Thelevelofyour
personal debts 1 2 3 4 5 6 7 Y 63/
F;Tj
~ 80~l
as well as its own employees. Done only by IRS
employees 2
Do you think the IRS should use
outside contractors to contact tax- Doesn't matter (vol.) ...3
payers for the purpose of explaining
the options that are available for Don't know y
paying taxes that are past due, or
should this be done only by IRS 13. If you personally owed back taxes to
employees? the IRS, would it bother you more to
receive a call from an outside con-
Use outside contractors .1 6/ tractor rather than an IRS employee,
or wouldn8t it make a difference
Done only by IRS which one called?
employees 2
Would bother me more
Doesn't matter (vol.) .3 <1 to recieve call from
Don't know y contractor 1 8/
Wouldn't make a
difference 2
Don't know y
14. Turning to a different subject, times today are, of course, different than when your parents were your age. But taking into
account those differences, would you say that compared to your parents, you (read each item)1 about the same
amount, or less?
J~ SAME LESS ~
a. Have more fun 1 2 3 Y 9/
b. Have more success financially 1 2 3 Y 10/
c. Have a happier family . 1 2 3 Y 11/
d. Work harder 1 2 3 Y 12/
e. Have more time to enjoy life 1 2 3 Y 13/
f. Have more stress 1 2 3 Y 14/
g. Have more wisdom 1 2 3 Y 15/
e. Yourjob 5 n. Talkingonthetelephone 2
f. Economicnews 6 0. Writingletters 3
g. Newsaboutfor~ignaffairs 7 p. Yardwork 4
h. What's goingon inWashington 8 q. Doinghousehold repairs S
i. SportsonTV 9 None 6
j. MostentertainmentshowsonTV.O Don'tknow Y
16. There has been a move to change the form of address for women from Miss and
Mrs. to Ms. Which form of address do you like best for women--Miss and Mrs., or Ms.?
MissandMrs 1 Don'tknow y 18/
Ms 2
17. Here is a list or household tasks. (HAND RESPONDENT CARD) Would you read down that list, and call off each one
you do at least occasionally?
18.
DIS- DIS
LIKE LIKE
17. EN- ~'T ~- GREAT ~'T
w JOY MIND WHAT DEAL ~
a. Shopping for food 1 19/ 1 2 3 4 Y 21/
b. Cookingineals 2 1 2 3 4 Y 22/
c. Washingdishes 3 1 2 3 4 Y 23/
d. Vacuuming 4 1 2 3 4 Y 24/
e. nusting S 1 2 3 4 Y 25/
f. Polishing furniture 6 1 2 3 4 Y 26/
g. cleaningbathroomorkitchenfloors 7 1 2 3 4 Y 27/
h. Cleaningbathtubs, showerstalls, sinks .8 (ASK 1 2 3 4 Y 28/
i. cleaningtoilets 9 18) 1 2 3 4 Y 29/
5. Cleaning glass, mirrors, windows 0 1 2 3 4 Y 30/
k. Cleaningtheoven X 1 2 3 4 Y 31/
1. Washing kitchen counters, sinks and
appliances Y 1 2 3 4 Y 32/
m. Doingthelaundry 1 20/ 1 2 3 4 Y 33/
n. Ironing 2 1 2 3 4 Y 34/
0. Recycling (bottles, cans, paper, etc.) .... 3 1 2 3 4 Y 35/
None 4~( SKIP
Don'tknow .YjTOl9)
18. Now for each of these tasks you do, would you tell me whether it is something you
enjoy doing, or something you don't mind doing, or something you dislike
somewhat, or something you dislike a great deal? (HAND RESPONDENT CARD)
b. Householdcleaners 2 2 2
c. Hard~e 3 3 3
d. T~s/gaees 4 4 4
e. Recordedmusic (tapes, CDs, etc.) S 5 5
f. Paperproducts (towels, napkins, etc.) 6 6 6
g. Magazines 7 7 7
h. Beer 8 8 8
1. Cigarettes 9 9 9
j. smallappliances 0 0 0
k. Frozen foods x x x
1. Cosmetics Y Y Y
m. Personal careproducts (shampoo, deodorant, etc.) .1 37/ 1 40/ 1 43/
n. Dressclothes 2 2 2
0. Casualciothes 3 3 3
p. Underwear, socks, hosiery 4 4 4
q. Shoes S 5 5
r. Fashion accessories (scarfs, ties, belts, etc.) . .6 6 6
S. Wine 7 7 7
t. Liquor 8 8 8
U. Towels, linens, sheets 9 9 9
V. Autoaccessories 0 0 0
w. Soft drinks x x x
x. Fruit juice Y Y Y
y. Snack foods 1 38/ 1 411 1 44/
z. Take-out/ready-to-eat food 2 2 2
aa. stationery/greeting cards 3 3 3
bb. Books 4 4 4
cc. Meat/poultry S 5 5
dd. Cold cereals 6 6 6
ee. Cold cuts 7 7 7
ff. Housewares (pots, pans, silverware, etc.) 8 8 8
Don't shopthere (vol.) 9 9 9
Don'tknow y Y Y
20. (USING SAME CARD) Using the same list of products would you call off the prod-
ucts you tend to buy when you shop in a convenience store such as 7-11, Circle K
and Mobil Mart? (RECORD ABOVE)
21. (USING SAME CARD) And finally, what products do you tend to buy when you S~op
(ASK EVERYO~)
43. Turning now to a different subject. There are differing opinions as to how health
insurance should be provided. Some people favor the present system of private insurance and health plans. Others say we
should have a national systern of health insurance provided through the government and paid for like Social Security now
is. Which do you favor--our present system of private health plans, or a national health insurance plan provided through
the government?
Present private plan 1 60/
National plan 2
Don't know Y
44. Thinking of all your medical care needs, not just the doctor, generally speaking, how satisfied would you say you are with
the ~ua1ity of the medical care you get--very satisfied, fairly well satisfied, not too satisfied, or not at all satisfied?
AiL I 45
QUALITY I AVAILABILITY OF MEDICAL CARE OF
MEDICAL CARE
Very satisfied 1 61/ 1 62/
Fairly well satisfied 2 2
Not too satisfied 3 I 3
Not at all satisfied 4 I
Don't know Y Y
45. And how satisfied are you with the availability of medical care when you need it--very satisfied, fairly well satisfied, not
too satisfied, or not at al ______
satisfied? (RECORD ABOVE) I 79-0 I
180-31
Fairly reasonable 2 Don8t know ......
Somewhat unreasonable .3
SO. Does the employer pay all or part of
Very unreasonable 4 the cost of that coverage?
Don't know Y All 1 10/
Part 2
Don8t know Y
47. How satisfied are you with the ar
rangements you have for paying for 51 Abou~ how much per month does the
medical care--very satisfied, fairly
employer pay for your medical and
well satisfied, not too satisfied, health coverage?
or not at all satisfied?
Very satisfied 1 7/ $ ____________________ 11/12/13/14
Fairly well satisfied .2 (write in)
Not too satisfied 3 Don't know Y
Not at all satisfied ... 4
52. And about how much per month, if
Don't know Y any, do you pay for your medical and
health coverage?
48. Do you and your family have any type $ ________________ 15/16/17/18
of health care plan or hospital (write in)
insurance?
Don't know Y
Yes 1 (ASK 49) 8/
53. Rising health insurance premiums may
require employers to reduce avail-
No 2 (SKIP TO 56 able health insurance benefits in
ON NEXT PAGE) future years or to reduce the amount
of future pay increases in order to
Some in family pay rising insurance costs. Which
covered, others would you prefer--to receive the
not (vol.) 3 (ASK 49) full amount of future pay increases
but have health insurance benefits reduced, or to
receive smaller future pay increases but keep
health insurance coverage at its current level?
Full increases, benefits reduced
Smaller increases,
current health coverage ...
2
increasing a good deal more
than
b. A traditional insurance the cost of living in general,
plan where you can choose
any doctoryouwant 2 (ASKSS) increasing somewhat more, in
creasing at about the same rate,
or increasing less than the cost
c. Medicare (over 65) 3 of living in general?
d. Veteran~sA&ministration; . .4
e. Medicaid S A good deal more 1 25/
Other (vol.) 6
Somewhat more 2
None/personally not
covered(vol.) 7 (SKIPTO56)
About the same 3
Dont know Y (ASKSS)
Less 4
55. Have you or any member of your family living with you ever been without a health
plan in the past two
years? Don~t know Y
Yes, went without . ....l (ASKS6) 21/
No ....2~ (SKIPTOSB)
Don~tknow
56. For how many months in the past two years have you or someone in your ~ami1y not
had a health plan?
Less than 3 months 1 22/
3 months to less than 6 months .2
6 months to less than 12 months .3
1 year to less than 2 4
2years (ormore) S
Dontknow Y
RIGHT RIGHT KNOW
a. T~s 1 2 Y 26/
b. Children~sclothesandaccessories 1 2 Y 27/
c. Recordedrnusic (CD8s, tapes, etc.) 1 2 Y 28/
d. Walkmantyperadiosorcassettes 1 2 Y 29/
e. Children~svideocassettes 1 2 Y 30/
f. G-ratedmovies 1 2 Y 31/
g. PG-13 ratedmovies 1 2 Y 32/
h. Sneakersandshoes 1 2 Y 33/
1. Cereal 1 2 Y 34/
j. Candy 1 2 Y 35/
k.Public service announcements about the
dangersofdrugs, smokinganddrinking 1 2 Y 36/
1.Public service announcements about the
dangersofunsafesex 1 2 Y 37/
m.900w type telephone nuinbers (recordings of music
andmoviestars, triviagames, sportsupdates) 1 2 Y 38/
60. Which of these sources have you used in the last six months to get infonnation on
the nutritional content of food--either fresh or packaged food? (HAND RESPONDENT
CARD)
I~IL
USED IN 1~T
6 MONTHS USEttL
a. Parnphletspublishedbyagovernmentagency 1 39/ 1 1 40/
b. Pamphlets prepared by food companies 2 I 2
c. Whatotherpeoplehavetoldyouaboutnutritioninfood ....3 1 3
d. Labels on food packages 4 1 4
Courses you took in school S I s
6 16
g. Newspaperarticles 7 I 7
h. Magazinearticles 8 I 8
1. Televisionprograms 9 I 9
Cookbooks 0 0
None .....X1( SKIP x
Don~tknow ....yjTO62)
61. Of those you have used, which one or two of those sources have you found useful on
the nutritional content of food? (RECORD ABOVE)
a. Food manufacturers 1 2 3 4 Y 41/
b. supermarkets 1 2 3 4 Y 42/
c. Fastfoodrestaurants 1 2 3 4 Y 43/
d. Restaurantswith~ableservice 1 2 3 4 Y 44/
e. Governinentagencies 1 2 3 4 Y 45/
f. publicschools 1 2 3 4 Y 46/
g. Themedia 1 2 3 4 Y 47/
65. Turning to something else, I'd like to talk with you now about games of chance, such as the lottery, off-track betting,
casino gambling, and so forth. (HAND RESPONDENT CARD) For each of the types of gambling or games of chance
on this card, please tell me whether or not you have done it in the past ~.
YES
a. Played games of chance like Bingo sponsored by
churchgroups, charitableorganizations etc 1 2 Y 50/
b. Playedanystate-runlotterygames 1 2 Y 51/
c. Betonahorserace .1 2 Y 52/
d. Betonadograce 1 2 Y 53/
e. Bet on a Jai-Alai (HIGH-lie) game 1 2 Y 54/
f. Gambled at a casino 1 2 Y 55/
g. Played card games for money, such as poker or black
jack, at a place other than a casino 1 2 Y 56/
h. Playednon-legalizednumbersgames 1 2 Y 57/
1. Placed sports bets, such as at your place of work,
in a betting parlor, or through a bookie 1 2 Y 58/
I INTERVIEWER: IF ~ ITEMS CIRCLED IN BOX, ASK Q.66. Fm\m79-o
IIF ~ ITEMS CIRCLED IN BOX, SKIP TO Q.67. 180-4180-51
69. Now here is a list of a number' of different things. (HAND RESPONDENT CARD) Would you read down that list and
call of f each one you personally have done in the last week, either at home or at work?
a. Goneshoppingforfood 1 28/
b. Bought take-out food to eat at home 2
c. Bought a (special) food product because of its nutritional content 3
d. Bought bottledwater 4
e. Usedacreditcard 5
f. Goneintoabank (business orpersonal) 6
g. Donebankingbymail (business orpersonal) 7
h. Donebankingbyphone 8
1. Usedanautomatictellermachine 9
j. Used an ATM card to pay for a purchase 0
k. Drankdecaffeinatedcoffee x
1. Drankdecaffeinatedtea 1 29/
m. Drank beer 2
n. Drankwine 3
0. Drank a wine cooler 4
p. Drankliquor S
q. smokedcigarettes (l/2packormore) 6
r. Made a long distance phone call (more than 100 miles) at home or
at work 7
5. Madeacollectphonecall 8
t. Tookbottles/canstorecyclingcenter 9
u. Returnedbottles/canstostore 0
v. Put outbottles/cans, etc., forcurbside recycling x
w. conetochurchorreligiousservice 1 30/
None 2
Don't know
L]L]L]L]LJ.00
421 431 441 45/ 46/
Refused X _____
179-01
Don8t know Y L:j6
72. Now I am going to ask you about non-essential spending in different categories. Without worrying how much it all adds
up to right now, about how much money would you say your household spends in an average month on (read item)?
If you aren't sure, just guess about how much. (ASK ABOUT EACH)
DON'T
AMOUNT NONE KNOW
a. Clothing for adults ... ~ X Y 6/7/8/9
b. Clothing for children . $ ~ 0 0 x Y 10/11/12/13
C. Movies, concerts,
sports events $ ~ .00 x Y 14/1S/16
d. Dining out . $ ~L]L]. 00 x Y 17/18/19
e. Travel, weekend
getaways ~ .00 x Y 20/21/22/23
f. Tapes, records, CDs,
videos1 etc .. $ Lffi~LJ. 00 x Y 24/25~2~
g. Things for the home ... ~ X Y 27/28/~9<3
h. Reading materials (books, magazines and
newspapers) . $ Lififfiliffi . ~ X Y
~~mimlml~ c\n ..
L]L]DL]LZ.00
421 431 441 45/ 46/
Refused X
Fm\
Don't know Y L:j6
72. Now I am going to ask you about non-essential spending in different categories. Without worrying how much it all adds
up to right now, about how much money would you say your household spends in an average month on ~tein? If you
aren't sure, just guess about how much. (ASK ABOUT EACH)
DON5T
AMOUNT NONE KNOW
a. Clothing for adults ... ~ X Y 6/7/8/9
b. Clothing for children . $ L]IzL]L].00 X Y 10/11/12/13
c. Movies, concerts,
sports events $ ~ .00 x y 14/15/16
d. Dining out $ ~['L]. 00 x y 17/18/19
e. Travel, weekend
getaways ~ jffiffijffij~ .00 x y 20/21/22~23
f. Tapes, records, CDs,
videos, etc $ Lffi~m'. 00 x Y 24/25~26
g. Things for the home ... ~ X Y 27/28~~?i3O
h. Reading materials
(books, magazines and ~ 00
newspapers) ~ Lffiffijffij~ X Y 3.'
I'm going to read a list of some characteristics people might have. For each one,
would you tell ~me which you think is more important in determining why people are the
way they are--heredity or environment? First, (read item). Is that more due to
heredity or environment? (ASK ABOUT EACH ITEM)
~ E~WI~
(STATE- (STATE
1~~'r ~ EQ(L~LLY ~'T
A) B) (VOL.)
a. How well a person reads 1 2 3 Y 39/
b. Whether a person is overweight or not ... 1 2 3 Y 40/
c. Whether a person is likely to have
a heart attack 1 2 3 Y 41/
d. Whether someone becomes an alcoholic ... .1 2 3 Y 42/
e. Whether someone is a heterosexual or
homosexual 1 2 3 Y 43/
f. Whether someone is a great athlete 1 2 3 Y 44/
g. Whether someone gets cancer 1 2 3 y 45/
h. Whether someone becomes a great
artist or musician 1 2 3 Y 46/
Very conservative 1 6/
Moderately conservative .... 2 D-5. Are you (CALL OFF APPROPRIATE
Middle-of-the-road 3 CATEGORIES):
Moderatelyliberal 4 Ahomemaker 1 11/
Very liberal 5 Unempl~ed 2
Don'tknow y
Astudent (SKIP
D-2. Regardless of how you may have Retired 4 TOD-7)
voted in the past, what do you Orwhat? (all other) . Y usually
consider yourself--a
Democrat, a Republican, some D-6. What is your occupation? other party or
what?
Executive, administrative, management.....
1 12/
Democrat 1 7/ Toptalentandmajororlesser
Republican 2 professional 2
Other specific party 3 Owner--small retail store/business 3
Independent (Vol.) 4 Farmers (owners and managers) 4
No particular party (Vol.) S Technicians, minoradministrative S
Refused 6 White collar, clerical (non-supervisory) .6
Don'tknow y Salesmen 7
D-3. Now here is a list of things some Skilledandsemi-skilledlabor 8
people do about government or Unskilled labor 9
politics. (HAND RESPONDENT CARD) Serviceandprotectiveworkers 0
Have you happened to have done
any of those things in the past
year? (IF YES") Which ones? (A~K EVERYONE)
D-7. Do you, or does anyone in your
a.WrittenyouroongressmanorSenator 1 8/ family living here at home belong to
b. Attended apolitical rally a labor union?
or speech 2 13/
c. Attended a public meeting on Respondent belongs to union 1
town or school affairs 3 Other family member only belongs to union
.2
d. Heldorrunforpoliticaloffice .. 4 Noonebelongstounion 3
Served on a committee for
somelocalorganization S Don'tknow Y
f. Served as an officer of some
clubororganization 6 D-8. Are you married, widowed, separated,
g. Writtenalettertothepaper 7 divorced or have you never been
h. Signedapetition 8 married?
i Workedforapoliticalparty 9 Married .. 1 (ASK 14/
j. Madeaspeech 0 D-9)
k. Written an article for a Widowed 2 1
magazine or newspaper X I (SKIP
1. Been a member of some group Separated or
divorce 3 I
like the League of Women d.
Voters, or some other group Neverbeenmarried.... j D-10)
interestedinbettergovernment . 1 9/ 4
No--noneof these 2
Very conservative 1 6/
Moderately conservative . ... 2 D-5. Are you (CALL OFF APPROPRIATE
Middle-of-the-road 3 CATEGORIES):
Moderatelyliberal 4 Ahomernaker 1 11/
Very liberal 5 Unemployed 2
Don'tknow Y Astudent 3 (SKIP
D-2. Regardless of how you may have Retired 4 TOD-7)
voted in the past, what do you Orwhat? (all other) . Y
usually consider yourself--a
Democrat, a Republican, some D-6. What is your occupation? other party or
what?
Executive, administrative, management 1 12/
Democrat 1 7/ Toptalentandmajororlesser
Republican 2 professional 2
Otherspecificparty 3 Owner--smallretailstore/business 3
Independent (Vol.) 4 Farmers (owners and managers) 4
No particular party (Vol.) S Technicians, minoradministrative
Refused 6 White collar, clerical (non-supervisory) .6
Don'tknow Y Salesmen 7
D-3. Now here is a list of things some Skilledandseini-skilledlabor 8
people do about government or Unskilled labor 9
politics. (HAND RESPONDENT CARD) Serviceandprotectiveworkers 0
Have you happened to have done
any of those things in the past
year? (IF YES~) Which ones? (ASK EVERYONE)
D-7. Do you, or does anyone in your
a. WrittenyourcongressmanorSenator 1 8/ ~amily living here at home belong to
b. Attendedapolitical rally a labor union?
or speech 2 13/
c. Attended a public meeting on Respondent belongs to union 1
town or school affairs 3 Other family member only belongs to union
.2
d. Heldorrunforpoliticaloffice .. 4 Noonebelongstounion 3
e. Served on a committee for
somelocalorganization S Don'tknow Y
f. Served as an officer of some
clubororganization 6 D-8. Are you married, widowed, separated,
g. Writtenalettertothepaper 7 divorced or have you never been
h. Signedapetition 8 married?
i Workedforapoliticalparty 9 Married . 1 (ASK 14/
j. Madeaspeech 0 D-9)
k. Written an article for a Widowed 2 1
magazine or newspaper X I (SKIP
1. Been a member of some group Separated or divorce 3 I
like the League of Women d.
Voters, or some other group Neverbeenmarried.... j D-10)
interestedinbettergovernment . 1 9/ 4
No--noneofthese 2
(ASK EVERYONE) Highschool graduate (12) 4
D-10. Are you a parent or not? Some college (13-15) 5
College graduate (16).... 6
Yes 1 16/ Post gradua~e (17+) 7
No 2
D-16. Here is a list of age groups.
D-ll. Are there any children living here (HAND RESPONDENT CARD) Would
at home with you: (RECORD FOR EACH you call off the letter of the
CATEGORY) age group you happen to be in?
(IF REFUSED, INTERVIEWER ESTI
Age3oryounger? Yes . 1 No . 2 17/ MATE GROUP)
a. 18 - 20 1 25/
Age 4 through 7? Yes . 1 No . 2 18/ b. 21 - 24 2
Age 8 through 12? Yes . 1 No . 2 19/ c. 25 - 29 3
d. 30 - 34 4
Age 13 through 17? Yes . 1 No . 2 20/
e. 35 - 39 5
D-12. Do you own your own home, rent it, f. 40 - 44 6
or do you have some other arrange- g. 45 - 49 7
ment such as living in the home of h. 50 - 54 8
your parents or children? 1. 55 - 59 9
j. 60 - 64 0
Own 1 21/ k. 65 - 69 x
Rent 2 1. 70orolder Y
Live in home of parents 3
Live inhomeofchildren 4 D-17. Now here is a list of income
Other (vol.) S categories. (HAND RESPOND~NT
CARD) Would you call off the
D-13. Do you consider yourself the male/ letter of the category that best
female head of this household or describes
the corribined annual
not? income of a1~ members of this
household, including wages or
Malehead 1 22/ salary, pensions, interest or
Feinalehead 2 dividends, and all other sources?
Another adult living in
a. Under $7,000 . 1 26'
the house 3
b. $7,000 to $9,999 2
D-14. Do you personally do most of the c. $10,000 to$14,999 3
grocery shopping for your house- d. $15,000 to $19,999 4
hold, or does somebody else do most e. $20,000 to $24,999 5
of it? f. $25,000 to $29,999 6
g. $30,OOOto$34,999 7
Respondent 1 23/ h. $3S,000 to$39,999 8
sornebodyelse 2 i. $40,000 to $49,999 9
Sharedequally (vol.) 3 j. $50,000 to $74,999 0
Nobodydoesit (vol,) 4 k. S75.000 andover x
INTERVI~ER RECORD
Male 1 28/ White 1 29/
Fernale 2 Black 2
Asian 3
Other 4
NAME
ADDRESS
APT. #
CITY OR TOWN___________________________
STATE ________________________________
ZI? CODE _______________________________ (30-34)
AREA CODE _________ TELE #_______________________ (35-44)
MONTH/DAY/Y~ _____________________________ (45-54)
Dayofweek:
First Saturday 1 Wednesday 5 55/
Sunday 2 Thursday 6
Monday 3 Friday 7
Thesday 4 secondSaturday 8
INTERVIEWERS NAME: _________________________________________ ______
179-01
180-91