Instructions:
The following questions ask whether different events have happened to you in the last 10 years. Please indicate “yes” or “no” for each.
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In the last 10 years, have you ever…
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1 |
a |
__Yes __No |
Rented a movie |
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b |
__Yes __No |
Returned a movie you rented without having watched it at all |
2 |
a |
__Yes __No |
Bought new clothes or shoes |
|
b |
__Yes __No |
Bought new clothes or shoes you never wore |
3 |
a |
__Yes __No |
Gone shopping for food or groceries |
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b |
__Yes __No |
Threw out food or groceries you had bought, because they went bad |
4 |
a |
__Yes __No |
Done your own laundry |
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b |
__Yes __No |
Ruined your clothes because you didn't follow the laundry instructions on the label |
5 |
a |
__Yes __No |
Been enrolled in any kind of school |
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b |
__Yes __No |
Been suspended from school for at least one day for any reason |
6 |
a |
__Yes __No |
Had any kind of job |
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b |
__Yes __No |
Quit a job after a week |
7 |
a |
__Yes __No |
Had a driver’s license |
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b |
__Yes __No |
Had your driver's license taken away from you by the police |
8 |
a |
__Yes __No |
Driven a car |
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b |
__Yes __No |
Been accused of causing a car accident while driving |
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c |
__Yes __No |
Gotten more than 5 parking tickets |
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d |
__Yes __No |
Gotten more than 5 speeding tickets |
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e |
__Yes __No |
Gotten lost or gone the wrong way for more than 10 minutes while driving |
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f |
__Yes __No |
Locked your keys in the car |
9 |
a |
__Yes __No |
Bought any kind of car |
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b |
__Yes __No |
Had to spend at least $500 to fix a car you had owned for less than half a year |
10 |
a |
__Yes __No |
Taken a trip by airplane |
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b |
__Yes __No |
Missed a flight |
11 |
a |
__Yes __No |
Taken the train or the bus |
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b |
__Yes __No |
Taken the wrong train or bus |
12 |
a |
__Yes __No |
Had any form of ID (driver’s license, passport, birth certificate) |
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b |
__Yes __No |
Had your ID replaced because you lost it |
13 |
a |
__Yes __No |
Lived in a rented apartment or other rental property |
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b |
__Yes __No |
Been kicked out of an apartment or rental property before the lease ran out |
14 |
a |
__Yes __No |
Carried a key to your home |
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b |
__Yes __No |
Had the key to your home replaced because you lost it |
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c |
__Yes __No |
Locked yourself out of your home |
15 |
a |
__Yes __No |
Been responsible for electricity, cable, gas or water payments |
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b |
__Yes __No |
Had your electricity, cable, gas or water shut off because you didn't pay on time |
16 |
a |
__Yes __No |
Been responsible for a mortgage or loan |
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b |
__Yes __No |
Foreclosed a mortgage or loan |
17 |
a |
__Yes __No |
Been responsible for rent or mortgage payments |
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b |
__Yes __No |
Paid a rent or mortgage payment at least 2 weeks too late |
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In the last 10 years, have you ever…
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18 |
a |
__Yes __No |
Used checks |
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b |
__Yes __No |
Had a check bounce |
19 |
a |
__Yes __No |
Had a credit card |
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b |
__Yes __No |
Had more than $5000 in credit card debt |
20 |
a |
__Yes __No |
Invested in the stock market |
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b |
__Yes __No |
Lost more than $1000 on a stock-market investment |
21 |
a |
__Yes __No |
Been to a bar, restaurant, or hotel |
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b |
__Yes __No |
Been kicked out of a bar, restaurant, or hotel by someone who works there |
22 |
a |
__Yes __No |
Loaned more than $50 to someone |
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b |
__Yes __No |
Loaned more than $50 to someone and never got it back |
23 |
a |
__Yes __No |
Had a romantic relationship that lasted for at least 1 year |
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b |
__Yes __No |
Cheated on your romantic partner of 1 year by having sex with someone else |
24 |
a |
__Yes __No |
Been married |
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b |
__Yes __No |
Been divorced |
25 |
a |
__Yes __No |
Had sex |
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b |
__Yes __No |
Been diagnosed with an STD |
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c |
__Yes __No |
Had an unplanned pregnancy (or got someone pregnant, unplanned) |
26 |
a |
__Yes __No |
Had sex with a condom |
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b |
__Yes __No |
Had a condom break, tear, or slip off |
27 |
a |
__Yes __No |
Had an alcoholic drink |
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b |
__Yes __No |
Consumed so much alcohol you vomited |
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c |
__Yes __No |
Received a DUI for drunk driving |
28 |
a |
__Yes __No |
Been out in the sun |
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b |
__Yes __No |
Got blisters from sun burn |
29 |
a |
__Yes __No |
Been in a jail cell overnight for any reason |
30 |
a |
__Yes __No |
Been in a public fight or screaming argument |
31 |
a |
__Yes __No |
Declared bankruptcy |
32 |
a |
__Yes __No |
Forgotten a birthday of someone close to you and did not realize until the next day or later. |
33 |
a |
__Yes __No |
Been diagnosed with type 2 diabetes |
34 |
a |
__Yes __No |
Broke a bone because you fell, slipped, or misstepped |