Socioeconomic Status Survey
Please answer the following questions to help us assess socioeconomic conditions. Your responses will remain confidential and are used for research purposes only.
Full Name
*
First Name
Last Name
Age
*
Gender
*
Male
Female
Non-binary/Other
Prefer not to say
Highest Level of Education Completed
*
Please Select
No formal education
Primary education
Secondary education
Vocational/Technical training
Undergraduate degree
Graduate degree
Other
Employment Status
*
Employed full-time
Employed part-time
Self-employed
Unemployed
Student
Retired
Homemaker
Other
What is your total monthly household income (before taxes)?
*
Please Select
Less than $1,000
$1,000 - $2,499
$2,500 - $4,999
$5,000 - $7,499
$7,500 - $9,999
$10,000 or more
Prefer not to say
How many people live in your household (including yourself)?
*
Housing Situation
*
Own home
Renting
Living with family/friends (no rent)
Other
Household Asset Ownership (select all that apply)
*
Car
Computer/Laptop
Smartphone
Refrigerator
Washing Machine
Television
Internet Access at Home
None of the above
Please indicate your level of agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I feel financially secure.
1
2
3
4
5
I have access to quality education.
6
7
8
9
10
My household has access to necessary healthcare.
11
12
13
14
15
I can afford basic necessities (food, clothing, shelter).
16
17
18
19
20
How would you rate your overall quality of life?
*
1
2
3
4
5
Submit Survey
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