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      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 direc~ion

    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 inost Federal Government departments and agencies? There

    may be exceptions, of course, but would you say your opinion of inost Federal

    Departments and agencies is highly favorable, or moderately favorable, or not too

    favorable, or rather Wifavorable?

               Highly favorable    1                        24/

               Moderately favorable                         .2



               Not too favorable   3



               Rather 3jflfavorable     4



               Don't 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 you more, less, or the same as the average person in this country?

                       ~RE     LE~S   THœSAM~

  a. Violent crime                1              2                 3     Y    33/

  b. Pollution                    1              2                 3     Y    34/

  c. Economic hardship            1              2                 3     Y    3S/

  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

    etnnic minorities than they have on other people.  (USING SAME CARD)  For each one, please tell me if you think i~

    affects racial and ethnic minorities more, less, or about the same as other people?

                                      AB~

                               Lœ~S  THESJ~

  a. Violent crime                1              2                 3     Y    39/

  b. Pollution                    1              2                 3     Y    40/

  c. Economic hardshiD            1              2                 3     Y    41/

  f. Assault                                             6

  g. Racketeering, extortion                             7

  h. Drugs                                               8

  i. Prostitution                                        9

  j. Speculationandswindling                             0

  k. Other                                               1  46/

     Noneoftheabove(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 tour things do you

                         about some different problems in          think are the main causes of people

                         society and for each one I want you       becoming drunk drivers?

                         to tell me what ~ think are the                                     DRUNK

                         major causes of each problem.                                       DRIVING

                         First, violent crime.  (HAND RESPON

                         DENT CARD)  Using this card, which    a. Livinginpoverty             

1   49/

                         three or tour things do you think     b. Parents not teaching

                         are the main causes of people com

                         mitting violent crimes?         right from wrong                     

2

                                                  VIOL~7"      c. Being abused as a child     3

                                                   CRIME       d. Drug abuse                  4

a.                Living inpoverty                            ~            47/     e. Whatpeopleseein'I'vprograms     5

b.                Parents not teaching                                             f. Alackofmorals              

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 'r'V programs    5

                          j.                  Influenceoffriends     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

j.                Influenceoffriends                           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.  Lowchanceofbeingpunished              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.                Seeing pornography                           4     None of these  S

                              AL~

                                 ~T  REAL DIS-         L

                           ~  ~TIS-  F~L~ SA77S-      L   BOILZZ17  m&"r

          ~              P14~~ FlED  ~    FIED  Al~Y  M'n



a.  The way things are going for you personally these

            days           1               2               3              4              5              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

            econosy              1              2               3              4              5              6              7     Y    53/



d.  How congress is dealing

            withtheecono~            1          2          3              4              5              6     -             7     Y    54/



e.  How your state government is dealing with the

            state's econ~            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              5              6     7    Y    57/



h.  Theamountofyour

            householdincose          1          2          3             4              5              6              7     y    SB/

i.          The ra~e of inflation          1               2              3              4              5              6              7     Y    69/



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              5              6              7     Y    61



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;;mi



                                                   LLLj

                               as well as its own employees.   Done oniy ty 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 wouldn't it make a difference

                          Done only by IRS                                               which one called?

                          employees               2

                                                                            Would bother me more

                          Doesn't matter (vol.)   .3                                       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), about the same amount,

    or less?



                                      SAME  L~~S  ~

  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                            S     n.   Talkingonthetelephone    2

                       f.    Economicnews                       6     0.   Writingletters           3

                       g.    Newsaboutforeignaffairs            7     p.   Yardwork                 4

                       h.    what'sgoingoninWashington.. 8                                          q.   Doinghousehold repairs   S

                       i.    SportsonTV                         9          None                     6

                       j.    Most entertainmen~ shows onT"'      .0        Don't know                        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 of household tasks.  (HAND RESPONDENT CARD)  Would you read down

    that list, and call off each one you do at least occasionally?

                                                    18.

                                                  DIS-  DIS

                                                   LlX~ LIXœ

                       77.     EN-              ~&'T ~- GRI~T ~'T

                       w       Joy           MIND  WHAT DEAL  ~

a.                   Shoppingforfood      1            19/          1              2              3              4     Y    21/

b.                   Cookingmeals         2                         1              2              3              4     Y    22/

c.                   washingdishes        3                         1              2              3              4     Y    23/

d.                   vactsuing       4                              1              2              3              4     Y    24/

e.                   Dus~ing         5                              1              2              3              4     Y    2S

f.                   Polishing furni~ure        6                                  1              2              3              4     Y    26/

g.                   cleaningba~hroomorki~chenfloors                      7                                      1              2              3              4     Y    27/

h.                   c1eaningba~htubs, showerstalls, sinks                .8                   (ASK              1              2              3              4     Y    28/

i.                   cleaning ~oilets           9          18)                     1              2              3              4     Y    29/

j.                   cleaningglass. 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/

                     IL       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 ..YjTO19)





18. Now for each of these tasks you do, would you tell me whether it is something

                                 b.  Householdcleaners           .2                             2                             2

                                 c.  Hardware           3                                       3                             3

                                 d.  Toys/games               4                                 4                             4

                                 e.  Recordedmusic (tapes, CDs, etc.)            5                             5                             5

                                 f.  Paperproducts (towels, napkins, etc.)                      6                             6                             6

                                 g.  Magazines          7                                       7                             7

                                 h.  Beer          8                        8                                  8

                                 i.  Cigarettes               9                                 9                             9

                                 j.  Smallappliances          0                                 0                             0

                                 k.  Frozen foods             x                                 x                             x

                                 1.  Cosmetics          Y                                       Y                             Y

                                 IL  Personal careproducts (shampoo, deodorant,          etc.) .1            37/              1            40/              1     43/

                                 n.  Dressclothes             2                                 2                             2

                                 0.  Casualdothes             3                                 3                             3

                                 p.  Underwear, socks, hosiery              4                                  4                             4

                                 q.  Shoes              5                                       5                             5

                                 r.  Fashionaccessories (scarfs, ties, belts, etc.)          . .6                             6                             6

                                 S.  Wine          7                        7                                  7

                                 t.  Liquor             8                                       B                             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            41/              1     44/

                                 z.  Take-out/ready-to-eat food             2                                  2                             2

                                 aa. stationery/greetingcards               3                                  3                             3

                                 bb.Books                     4                                 4                    4

                                 cc. Meat/poultry             S                                 S                             S

                                 dd. Cold cereals             6                                 6                             6

                                 ee.Coldcuts                                7                                  7                    7

                                 ff. Housewares (pots, pans. silverware, etc.)                  8                             8                             8

                                     Don't shop there (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)

    (ASK EVERYONE)

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 system 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 ouplity of the medical care you get--very satisfied, fairly well satisfied, not too satisfied, or not at all satisfied?

                                      44.    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

               Fairly reasonable                        2     Don't know     

                                  Somewhat unreasonable .3

                                               50.    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

                                               Don't know     Y

47. How satisfied are you with the ar

                           rangements you have for paying for           51     About 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 fu

                                       ture pay increases but keep

health

                                       insurance coverage at its current

                                       level?



                             Full increases, benefits reduced    .1 ?'

                                          increasing a good deal more than

                                b.   A traditional insurance  the cost of living in general1

                                plan where you can choose

                                anydoctorycuwant    2    increasing somewhat more, in

                                                        (ASKSS)    creasing at about the same rate,

                                                         or increasing less than the cost

               C.               Medicare (over 65)  3    of living in general?





    d.   Veteran'sA&ftinistration; . .4

               e.               Medicaid                       5     A good deal more             1     25/

                                Other (vol.)                   6

                                Somewhat more                 2

                 None/personally not

               covered(vol.)  7 (SKIPTOS6)

                                About the same                 3

               Don'tknow 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  (A5K56)             21/

         No   ....2~ (SKIPTOSB)

         Don'tknow        





56. For how many months in the past two years have you or someone in your family 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

                  Don'tknow Y

                                 RIGHT  RIGHT    ~Ow

                                   a.      Toys            1          2     Y    26/

                                   b.      children'sclothesandaccessories           1              2     Y    27/

                                   c.      Recordedmusic (cD's, 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/

                                   i.      Cereal          1          2     Y    34/

                                   j.      Candy           1          2     Y    35/

                                   k.Public service announcements about the

                                           dangers of drugs, smoking anddrinking          1              2     Y    36/

                                   1.Public service announcements about the

                                           dangersofunsafesex                             1              2     Y    37/

                                   m.      "900~ type telephone numbers (recordings of music

                                           andmoviestars, triviagames, sportsupoates)          1              2     Y    38/





60. Which of these sources have you used in the last six months to get information on

    the nutritional content of food--either fresh or packaged food?  (HAND RESPONDENT

    CARD)

                              60.

                             USEDIN

                                     6 MONTHS   USEPUL

                                        a.  Pamphletspublishedbyagovernmentagencv             1            39/     I    1  40/

                                        b.  Pamphlets prepared by food companies              2                    I    2

                                        c.  Whatotherpeoplehavetoldyouaboutnutritioninfood                    ....3          I    3

                                        d.  Labels on food packages                           4                    I    4

                                       Courses you took in school    S      I    s

                                       Advertisementsforfoodproducts                         6      I   6

                                        g. Newspaperarticles     7             I     7

                                       h.     Magazinearticles   a    I    ~

                                                 1.    Televisionprograms           9     I             9

                                        3KCookbooks             0              0

                                   None           .....X1( SKIP  X

                                    Don~tknow ....yjTO62) I

                                                       Y

  a.                          Food manufacturers           1              2              3              4     Y    411

  b.                          Supermarkets             1             2                   3              4     Y    42/

  c.                          Fast food restaurants                  1                   2              3              4     Y    43/

  d.                          Restaurantswithtableservice            1                   2              3              4     Y    44/

  e.                          Government agencies          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 vea~.

                                                    YES

                                       a.       Played games of chance like Bingo sponsored by

                                                churchgroups, charitableorganizations, etc   1             2     Y    501

                                       b.       Playedanystate-runlotterygames               1             2     Y    51/

                                       c.       Bet on a horse race                          .1            2     Y    52/

                                       d.       Bet on a dog race                            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    SB/

69. Now here is a list of a number of different things.  (HAND RESPONDENT CARD) Would

    you read down that list and call off 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

                                                  a.             Bought bottledwater     4

                                                  e.  Usedacreditcard     S

                                                  f.Gone intoabank (business orpersonal) 6

                                                  g.Donebankingbymail (businessorpersonal)                             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.        Drankbeer     2

                                                  n.        Drankwine     3

                                                  0. Drankawinecooler     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.  Gonetochurchorreligiousservice     1                             30/

                                                           None                    2

                                                           Don'tknow               Y

                        $ L]L]L]L]L].oo

              42/ 43/ 44/  45/ 46/



               Refused . x

                                                          F:7o

               Don't know          Y                      180-61











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 . $ LiLItzL]~ 0 0   x    y    10/11/12/13

                     c.   Movies, concerts,   r-i~~

                                         sports events     $ LffiDjm\  00     x    Y    14/15/16

                   d.                    Dining out        $ L]['Lz~ 00   x    Y    17/18/19

                                         e.   Travel, weekend

                                              getaways     x    Y    20/21/22/23





    f.   Tapes, records, CDs,

                    videos, etc          $ Lifimilifi. 00  x    Y    24/25/26

                                         g.   Things for the home ... $ ~ 0 0  x    Y    27/28/29130

                                    h.   Reading materials

                                         (books, magazines and    nn

                                         newspapers)    ~'-'      x    Y    31'~2

I'm going to read a list of some characteristics people might have.  For each one,

would you tell ine 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)



                              ~ITy

                         (STATE-   (STA~MEN"     MEN"   EQ(~Y  

                         ~'T

                          A)     B)     (V~L.)

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

                          aheartattack    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 bocomes a great

                           artist or musician             1            2              3     Y    46/

                    Veryconservative . 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    Unemployed              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

              Otherspecificparty                                 3                    Owner--smallretailstore/business   3

              Independent (Vol.)                                 4                    Farmers (owners andmanagers)       4

              No particular party (Vol.)                         S                    Technicians, minor administrative  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?                                        (ASK EVERYONE)

                                                                       D-7.      Do you, or does anyone in your

a.WrittenyourcongressmanorSenator  1                           8/                family living here at home          belong to

b.                           Attendedapolitical rally a labor union?

                   or speech                                         2     13/

c.                        Attendedapublicmeetingon      Respondentbelongstounion 1

                   town or school affairs              3     Other family member only belongs to union

.2

d.                        Held or run for political office ..  4  No one belongs to union  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               a       married?

i                 Worked forapolitical party             9                      Married     1                 (ASK   

14/

j.               Madeaspeech               0                                              D-9)

k.      Writtenanarticlefora                      Widowed   .  2

                  magazine or newspaper             x                                              1     (SKIP

1.                          Been a member of some group   Separated or divorced             3

                             like the League of Women                                             I n-i~~

                                F   fr                                 r k

                                (ASK EVERYONE)       Highschoolgraduate (12)           4

D-lO.                           Are you a parent or not?                      Some college (13-15)              S

                                college graduate (16)....  6

                  Yes     1   16/                        Post graduate (17+)      7

                  No      2

                               D-16.               Here is a list of age    groups.

D-11.           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

Age 3 or younger?  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              S

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.            SO           - 54              8

  your parents or                children?        1.           55           - 59              9

                                                     j. 60 - 64  0

                 Own      1    21/                                  k. 65 - 69  x

                 Rent     2                          1. 7oorolder               Y

                 Live in home of parents          3

                 Liveinhomeofchudren              4              D-17.          Now here is a list of    income

                 Other (vol.)  S                                 categories.  (HAND RESPONDENT

                                                  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 combined annual

                               not? income of all members of this

                              household, including wages or

                 Malehead    1    22/                  salary, pensions, interest or

                 Femalehead  2                    dividends, and all other

sources?

                 Another adult living in

                   the house 3 a.                 Under$7,000    1       26/

                               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  A

                hold, or does somebody else do most              e.                  $20,000 to $24,999  5

                of it?         f.                 $25,000 to $29,999                 6

                               g.                 $30,000 to $34,999                 7

                 Respondent  1    23/             h.   $35,000 to $39,999            8

                 somebodyelse  2                  i.   $40,000 to $49,999            9

                       INTERVIEWER RECORD

     Male .......  1               28/ wnite             1            29/

     Female              2  Black               2

                            Asian               3

                            Other               4



    NAME



    ADDRESS



    APT. #



    CITY OR TOWN___________________________



    ~I'ATE __________________________________



    ZIP CODE ________________________________ (30-34)



          AREA CODE ___________    TELE 1 ____________________________ (35-44)



    M~~/DAY/YEAR ______________________________ (45-54)





                           Davofweek:

             First Saturday            1          wednesday           5     55/

             Sunday                    2          Thursday            6

             Monday                    3          Friday              7

             Tuesday                   4          secondsaturday                8











INTERVIEWERS NAME. _________________________________________

                                                179-01

                                                ~80-9~

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