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Presidential Election Poll
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Personal Information
What is your gender? *
Male
Female
How would you classify yourself?*
Rather not say
Caucasian/White
African American
Indigenous or Aboriginal
Asian/Pacific Islander
Hispanic
Latino
Multiracial
Other
What is your marital status?*
Rather not say
Single
Married
Divorced
Widowed
What is your age?*
Rather not say
Under 13
13 - 15
16 - 20
21 - 25
26 - 29
30 - 39
40 - 49
50 - 59
60 - 69
70 or above
What is your annual household income?*
Rather not say
Under $10,000
$10,000 - $19,999
$20,000 - $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 _ $69,999
$70,000 - $79,999
$80,000 - $89,999
$90,000 - $99,999
$100,000 or above
Where are you located?*
U.S. North East
U.S. South East
U.S. Mid West
U.S. Great Plains
U.S. North West
U.S. South East
Canada
Describe the area you live in.*
Urban
Suburban
Rural
What is highest level of education completed?*
Grammar School
High School or equivalent
Vocational/Technical School
Some College
Associates Degree (2 year)
College Graduate (4 year)
Master`s Degree (MS)
Doctoral Degree (PhD)
Professional Degree (MD etc.)
Other
Are you currently registered to vote?*
Yes
No
How many children live in your household?*
None
1
2
3
4 or more
Employment or Business Information
What type of industry do you work in?*
Accounting
Advertising
Aerospace
Agriculture
Architecture
Automobile Sales
Automobile Service
Barbers/Cosmetology
Computer Hardware
Computer Services
Computer Software
Construction
Contractor
Credit/Collection
Diet & Exercise
Education
Engineering
Employment
Entertainment
General Consulting
Government
Health & Beauty
Healthcare
Hotel/Motel
Import/Export
Insurance
Legal Services
Manufacturing
Medical
Mining
Music
News Media
Nutrition
Pharmaceutical
Publishing/Printing
Ranch/Livestock
Real Estate
Restaurant/Bar
Retail Sales
Security
Service & Repair
Science & Research
Sports
Nutrition
Technology
Television/Radio
Tourism/Convention Services
Travel
Utilities
Veterinary/Animal Care
Other
What type of role do you perform?*
Upper Management
Middle Management
Junior Management
Administrative Staff
Support Staff
Student
Trained Professional
Skilled Laborer
Consultant
Temporary Employee
Researcher
Self-employed/Partner
Other
The organization you work for is in which of the following:*
Public sector (government)
Private sector (businesses)
Not-for-profit sector
Don`t know
Other
The main source of revenue for your organization is:*
Sales to individuals
Sales to private businesses
Sales to government
Contracts to individuals
Private business contracts
Government contracts
Other organization contracts
Government appropriations
User charges and fees
Donations
Other
Don`t know
Presidential Candidate Selection
Which presidential candidate would you vote for in the upcoming primary?*
Hillary Clinton
Barack Obama
Al Gore
John Edwards
Wesley Clark
Bill Richardson
Joe Biden
Dennis Kucinich
Chris Dodd
Tom Vilsack
Other
Wouldn`t vote
Unsure
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