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Scenerio ID   *
First Name   * Last Name   *
User ID   * User Password   *
Organization   Role in Organization  
Street Address   City  
State   Zip Code  
Phone Number   Email Address   *

Gender   Male
  Female
Marital Status   Married
  Divorced or Separated
  Widowed
  Single never married
Age Status   14-17
  18-24
  25-34
  35-44
  45-54
  55-64
  65+
Highest Level of Formal Education Completed   Grade 8 or less
  Graduated High School
  1-3 years of College
  Graduated College (4 years)
  Attended or Completed Grad School
Current Occupation   Professional/Managerial
  Retired
  Clerical or Service Worker
  Homemaker
  Factory Worker/Laborer/Driver
  Unemployed
  Salesperson
  College Student
  Military
Annual Household Income   Less than $15,000
  $15,000 to $24,999
  $25,000 to $34,999
  $35,000 to $49,999
  $50,000 to $74,999
  $75,000 to $99,999
  $100,000 to $149,999
  $150,000 or more
Number of Persons in Household   1
  2
  3
  4
  5+
Number of Children in Household   0
  1
  2
  3
  4+