| 1. |
What was your age on your last birthday? |
years
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| 2. |
What is your gender? |
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| 3. |
What is the highest level of education you have completed? |
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| 4. |
Which of the following best describes your employment status? |
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For each of the following characteristics, please specify a number from 0 to 10, where '0' means the statement 'Does Not Describe Me at All' and '10' means it 'Describes Me Completely'. |
| 5. |
I am true to myself. |
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| 6. |
I dress with flair and a sense of style. |
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| 7. |
I trust God to take care of things. |
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For each of the following statements, please indicate whether you Strongly Disagree, Disagree, Neither Agree or Disagree, Agree, or Strongly Agree. |
| 8. |
I prefer to buy brands that are respectful of my cultural background. |
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| 9. |
It's important for me to preserve my cultural traditions, such as music and songs, recipes, history, and so on. |
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| 10. |
People should only marry within their race. |
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Please answer the following questions regarding your day-to-day activities and experiences. |
| 11. |
How much do you trust the police to treat you and your family fairly? When responding use a scale from 0 to 10 where '0' is 'Do Not Trust at All' and '10' is 'Trust Completely'. |
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| 12. |
How much worry or stress, if any, does your main personal relationship (like your husband, wife, boyfriend or girlfriend) cause you? Use a scale from 1 to 5 where '1' is 'None at All' and '5' is 'A Great Deal'. |
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| 13. |
To what degree do ads that reflect your culture and heritage persuade you to buy or try a new product or service? Use a scale from 1 to 5 where '1' is 'Does not persuade me at all' and '5' is 'Persuades me a lot'. |
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| 14. |
How often, if ever, do you do buy television shows on a DVD? |
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| 15. |
Approximately how much time do you spend on a typical Sunday using the internet (including email)? |
hrs
mins
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| 16. |
Approximately how much time in a typical week do you spend listening to iTunes, MP3s, etc. on a computer? |
hrs
mins
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| 17. |
Thinking of all the television you watch in an typical week, approximately what percent of the time do you watch channels focused on Blacks or African-Americans, such as BET, BETJ, CW/UPN, and TV ONE? |
%
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How often do you do the following activities? Would you say it is frequently, occasionally, rarely, or never? |
| 18. |
Attend a professional sporting event. |
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| 19. |
Donate money or items to religious or non-profit groups. |
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| 20. |
Travel for business. |
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