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Form NSCG-1 (3-5-99)
OMB No. 3145-0141:
Approval Expires 04/30/2001


1999 National Survey of College Graduates


This information is solicited under the authority of the National Science Foundation Act of 1950, as amended. Your report to the Census Bureau is confidential by law (Title 13, U.S. Code and the Federal Privacy Act of 1974). All information you provide will be treated as confidential and used only for research or statistical purposes by the survey sponsor (the National Science Foundation), their contractors, and collaborating researchers for the purpose of analyzing data and preparing scientific reports and articles. Any information publicly released (such as statistical summaries) will be in a form that does not personally identify you. Your response is voluntary and failure to provide some or all of the requested information will not in any way adversely affect you. Actual time to complete the questionnaire may vary depending on your circumstances. On the average, it will take about 20 minutes to complete the questionnaire. If you have any comments on the time required for this survey, please send them to Suzanne H. Plimpton, National Science Foundation, 4201 Wilson Boulevard, Suite 295, Arlington, VA 22230. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.
Conducted by: U.S. Department of Commerce BUREAU OF THE CENSUS for the National Science Foundation, Arlington, VA

INSTRUCTIONS
Thank you for taking the time to complete this questionnaire. Directions for filling it out are provided with each question. Because not all questions will apply to everyone, you may be asked to skip certain questions.
  • In order to get comparable data, we will be asking you to refer to the week of April 15, 1999 (e.g., April 11 ? April 17, 1999) when answering most questions
  • Follow all "SKIP" instructions AFTER marking a box. If no "SKIP" instruction is provided, you should continue to the NEXT question
  • Either a pen or pencil may be used
  • When answering questions that require marking a box, please use an "X"
  • If you need to change an answer, please make sure that your old answer is either completely erased or clearly crossed out
Thanks again for your help, we really appreciate it.

PART A ? Employment Status During the Reference Week of April 11 ? 17, 1999

A1.
Were you working for pay (or profit) during the week of April 15, 1999? This includes being self-employed or temporarily absent from a job (e.g., illness, vacation or parental leave), even if unpaid.
STUDENTS: Do NOT count financial aid awards with no work requirement
1 [ ] Yes (SKIP to A7)
2 [ ] No

A2.
(IF NO) Did you look for work during the four weeks preceding April 15, 1999 (that is, any- time between March 19 and April 15, 1999)?
1 [ ] Yes
2 [ ] No

A3.
What were your reasons for not working during the week of April 15?
Mark (X) all that apply
1 [ ] Retired, Year Retired: 19___ ___
2 [ ] On layoff from a job
3 [ ] Student
4 [ ] Family responsibilities
5 [ ] Chronic illness or permanent disability
6 [ ] Suitable job not available
7 [ ] Did not need or want to work
8 [ ] Other ? Specify ________________

A4.
Prior to the week of April 15, 1999, when did you last work for pay (or profit)?
0 [ ] Mark (X) this box if never worked for pay (or profit) and SKIP to Part D, page 6
LAST WORKED
Month: ___ ___ Year: 19___ ___

A5.
What kind of work were you doing on this last job ? that is, what was your occupation? Please be as specific as possible, including any area of specialization.
EXAMPLE: High school teacher ? Math
___________________________________________________
___________________________________________________
___________________________________________________

A6.
Using the JOB CODES LIST (pages 10?11), choose the code that BEST describes the work you were doing on this last job.
CODE ___ ___ ___ (SKIP to A36, page 5)
NOTE ? Job codes range from 010 to 500

A7.
(IF WORKED DURING WEEK OF APRIL 15TH) Counting all jobs held during the week of April 15, 1999, did you USUALLY work . . .
1 [ ] A total of 35 or more hours per week (SKIP to A10, page 2)
2 [ ] Fewer than 35 hours per week

A8.
(IF FEWER THAN 35 HOURS) During the week of April 15, did you want to work a full-time work week of 35 or more hours?
1 [ ] Yes
2 [ ] No

A9.
What were your reasons for working a part-time work week (i.e., less than 35 hours) during the week of April 15?
Mark (X) all that apply
1 [ ] Retired or semi-retired, Year Retired: 19 ___ ___ (SKIP to A11, page 2)
2 [ ] Student (SKIP to A11, page 2)
3 [ ] Family responsibilities (SKIP to A11, page 2)
4 [ ] Chronic illness or permanent disability (SKIP to A11, page 2)
5 [ ] Suitable full-time work week job not available (SKIP to A11, page 2)
6 [ ] Did not need or want to work full-time (SKIP to A11, page 2)
7 [ ] Other ? Specify: _____________________________ (SKIP to A11, page 2)

A10.
(IF 35 OR MORE HOURS) Although you were working during the week of April 15, had you previously RETIRED from any position?
Examples of retirement include mandatory retirement, early retirement, or voluntary retirement
1 [ ] Yes, Year Retired: 19 ___ ___
2 [ ] No

The next several questions ask about your principal employer.

A11.
Who was your principal employer during the week of April 15, 1999?
IF MORE THAN ONE JOB: Record employer for whom you worked the most hours that week
IF EMPLOYER HAD MORE THAN ONE LOCATION: Record location where you usually worked
Employer Name: _________________________________________
City/Town: ______________________________________________
State/Foreign Country: ____________________________________
ZIP Code: ________________________________________________

A12.
Thinking about your employer?s main business (i.e., what your employer makes or does), under which of these categories does your employer?s main business BEST fit?
IF PRINCIPAL EMPLOYER HAS MORE THAN ONE TYPE OF BUSINESS: Please answer for the type of business primarily performed at the location where you work
Mark (X) ONLY One
1 [ ] Agriculture, forestry, or fishing
2 [ ] Biotechnology
3 [ ] Construction or mining
4 [ ] Education
5 [ ] Finance, insurance or real estate services
6 [ ] Health services
7 [ ] Information technology or computer services
8 [ ] Other services (e.g., social, legal, business)
9 [ ] Manufacturing
10 [ ] Public administration/government
11 [ ] Research ? Specify: _________________________________
12 [ ] Transportation services, utilities or communications
13 [ ] Wholesale or retail trade
14 [ ] Other

A13.
Counting all locations where this employer operates, how many people work for your principal employer? Your best estimate is fine.
Mark (X) ONLY One
1 [ ] Under 10 employees
2 [ ] 10-24 employees
3 [ ] 25-99 employees
4 [ ] 100-499 employees
5 [ ] 500-999 employees
6 [ ] 1,000-4,999 employees
7 [ ] 5,000+ employees

A14.
Did your principal employer come into being as a new business within the past 5 years?
1 [ ] Yes
2 [ ] No

A15.
Was your principal employer during the week of April 15...
IF EMPLOYER WAS A SCHOOL: Mark (X) the type of organizational charter (e.g., mark "state government" for state schools: most private schools are "private not-for-profit")
Mark (X) ONLY One
1 [ ] A PRIVATE FOR-PROFIT company, business or individual, working for wages, salary or commissions
2 [ ] A PRIVATE NOT-FOR-PROFIT, tax-exempt, or charitable organization
3 [ ] SELF-EMPLOYED in own NOT INCORPORATED business, professional practice, or farm
4 [ ] SELF-EMPLOYED in own INCORPORATED business, professional practice, or farm
5 [ ] Local GOVERNMENT (e.g., city, county)
6 [ ] State GOVERNMENT
7 [ ] U.S. military service, active duty or Commissioned Corps (e.g., USPHS, NOAA)
8 [ ] U.S. Government (e.g., civilian employee)
9 [ ] Other ? Specify: ____________________________

A16.
Was your principal employer an educational institution?
1 [ ] Yes
2 [ ] No (SKIP to A18)

A17.
(IF EDUCATIONAL INSTITUTION) Was this educational institution a...
Mark (X) ONLY One
1 [ ] Preschool, elementary, or middle school or system
2 [ ] Secondary school or system
3 [ ] Two-year college, community college, technical institute
4 [ ] Four-year college or university, other than medical school
5 [ ] Medical school (including university-affiliated hospital or medical center)
6 [ ] University-affiliated research institute
7 [ ] Something else ? Specify: _________________________

The next set of questions ask about your work on your principal job.

A18.
What kind of work were you doing on your principal job held during the week of April 15, 1999 ? that is, what was your occupation? Please be as specific as possible, including any area of specialization.
EXAMPLE: High school teacher ? Math
______________________________________________________
______________________________________________________
______________________________________________________

A19.
Using the JOB CODES LIST (pages 10-11), choose the code that BEST describes the work you were doing on your principal job during the week of April 15.
CODE ___ ___ ___
NOTE ? Job codes range from 010 to 500

A20.
Did your duties on this job require the technical expertise of a bachelor's degree or higher in ...
Mark (X) Yes or No for each
1. Engineering, computer science, math, or the natural sciences
1 [ ] Yes 2 [ ] No

2. The social sciences
1 [ ] Yes 2 [ ] No

3. Some other field (e.g., health or business) ? Specify: ______________________
1 [ ] Yes 2 [ ] No

A21.
During what month and year did you start this job, (that is, your principal job held during the week of April 15, 1999)?
JOB STARTED
Month ___ ___ Year 19___ ___

A22.
Thinking about the relationship between your work and your education, to what extent was your work on your principal job held during the week of April 15 related to your HIGHEST degree field? Was it . . .
Mark (X) ONLY One
1 [ ] Closely related (SKIP to A25, page 4)
2 [ ] Somewhat related (SKIP to A25, page 4)
3 [ ] Not related

A23.
(IF NOT RELATED) Did these factors influence your decision to work in an area OUTSIDE OF YOUR HIGHEST DEGREE FIELD?
Mark (X) Yes or No for each
1. Pay, promotion opportunities
1 [ ] Yes 2 [ ] No

2. Working conditions (e.g., hours, equipment, working environment)
1 [ ] Yes 2 [ ] No

3. Job location
1 [ ] Yes 2 [ ] No

4. Change in career or professional interests
1 [ ] Yes 2 [ ] No

5. Family-related reasons (e.g., children, spouse's job moved)
1 [ ] Yes 2 [ ] No

6. Job in highest degree field not available
1 [ ] Yes 2 [ ] No

7. Other reason ? Specify: _________________________________
1 [ ] Yes 2 [ ] No

A24.
Which TWO factors in A23 represent your MOST important reasons for working in an area outside of your HIGEST degree field? Enter number of appropriate reasons from A23 above.
1. _____ MOST important reason
2. _____ SECOND MOST important reason (Enter "0" if no second most)

A25.
The next question is about your work activities on your principal job. Which of the following work activities occupied 10 percent or more of your time during a TYPICAL work week on this job?
Mark (X) Yes or No for each
1. Accounting, finance, contracts
1 [ ] Yes 2 [ ] No

2. Applied research ? study directed toward gaining scientific knowledge to meet a recognized need
1 [ ] Yes 2 [ ] No

3. Basic research ? study directed toward gaining scientific knowledge primarily for its own sake
1 [ ] Yes 2 [ ] No

4. Computer applications, programming, systems development
1 [ ] Yes 2 [ ] No

5. Development ? using knowledge gained from research for the production of materials, devices
1 [ ] Yes 2 [ ] No

6. Design of equipment, processes, structures, models
1 [ ] Yes 2 [ ] No

7. Employee relations ? including recruiting, personnel development, training
1 [ ] Yes 2 [ ] No

8. Managing and supervising
1 [ ] Yes 2 [ ] No

9. Production, operations, maintenance (e.g., truck driving, machine tooling, auto/machine repairing)
1 [ ] Yes 2 [ ] No

10. Professional services (e.g., health care, counseling, financial services, legal services)
1 [ ] Yes 2 [ ] No

11. Sales, purchasing, marketing, customer service, public relations
1 [ ] Yes 2 [ ] No

12. Quality or productivity management
1 [ ] Yes 2 [ ] No

13. Teaching
1 [ ] Yes 2 [ ] No

14. Other ? specify: _______________________
1 [ ] Yes 2 [ ] No

A26.
On which TWO activities in A25 did you work the MOST hours during a typical week on this job? Enter number of appropriate activity from A25 above.
1. _____ Activity MOST hours
2. _____ Activity SECOND MOST hours (Enter "0" if no second most)

A27.
Did you supervise the work of others as part of your principal job held during the week of April 15?
Mark "YES": If you assigned duties to workers AND recommended or initiated personnel actions such as hiring, firing or promoting
TEACHERS: Do NOT count students
1 [ ] Yes
2 [ ] No (SKIP to A29)

A28.
(IF YES) How many people did you typically...
IF NONE: Enter "0"
1. Supervise DIRECTLY? _____ (Number Supervised)
2. Supervise through subordinate supervisors? _____ (Number Supervised)

A29.
Before deductions, what was your basic ANNUAL salary on this job as of the week of April 15, 1999? (Do NOT include bonuses, overtime, or additional compensation for summertime teaching or research)
IF NOT SALARIED: Please estimate your earned income, excluding business expenses
$__________________________________.00
BASIC ANNUAL SALARY/EARNED INCOME

A30.
During a typical week on this job, how many hours did you usually work?
NUMBERS OF HOURS PER WEEK _____

A31.
Including paid vacation and paid sick leave, upon how many weeks per year was your salary based?
NUMBER OF WEEKS PER YEAR _____

A32.
During the week of April 15, 1999, were you working for pay (or profit) at a second job (or business), including part-time, evening, or weekend work?
1 [ ] Yes
2 [ ] No (SKIP to A36)

A33.
(IF YES) What kind of work were you doing at your second job during the week of April 15 ? that is, what was your occupation? Please be as specific as possible including any area of specialization.
IF MORE THAN TWO JOBS THAT WEEK: Answer for the job where you worked the second most hours
___________________________________
___________________________________
___________________________________

A34.
Using the JOB CODES LIST (pages 10-11), choose the code that BEST describes the work you were doing on your second job during the week of April 15.
CODE ___ ___ ___
NOTE ? Job codes range from 010 to 500

A35.
To what extent was you work on this second job related to your HIGEST degree field? Was it...
Mark (X) ONLY One
1 [ ] Closely related
2 [ ] Somewhat related
3 [ ] Not related

A36.
Thinking back to 1998 and counting all jobs held then, what was your TOTAL EARNED income for 1998, BEFORE deductions? Include all wages, salaries, bonuses, overtime, commissions, consulting fees, net income from businesses, summertime teaching or research, postdoctoral appointment, or other work associated with scholarships
$ ____________________________________.00
TOTAL 1998 EARNED INCOME
0 [ ] Mark (X) this box if you had no earned income in 1998

PART B ? Past Employment

The next few questions will help us better understand employment changes over time.

B1.
Were you working for pay (or profit) during BOTH of these time periods ? the week of April 15, 1997 AND the week of April 15, 1999?
IF YOU WERE A STUDENT: Do NOT count financial aid awards with no work requirement
1 [ ] Yes
2 [ ] No (SKIP to C1, page 6)

B2.
(IF YES) During these two time periods ? the week of April 15, 1997, and the week of April 15, 1999 ? were you working for...
Mark (X) ONLY One
1 [ ] Same employer AND same job (SKIP to C1, page 6)
2 [ ] Same employer BUT different job
3 [ ] Different employer BUT same job
4 [ ] Different employer AND different job

B3.
(IF DIFFERENT) Why did you change your employer on your job?
Mark (X) Yes or No for each
1. Pay, promotion opportunities
1 [ ] Yes 2 [ ] No

2. Working conditions (e.g., hours, equipment, working environment)
1 [ ] Yes 2 [ ] No

3. Job location
1 [ ] Yes 2 [ ] No

4. Change in career or professional interests
1 [ ] Yes 2 [ ] No

5. Family-related reasons (e.g., children, spouse's job moved)
1 [ ] Yes 2 [ ] No

6. School-related reasons (e.g., returned to school, completed a degree_
1 [ ] Yes 2 [ ] No

7. Laid off or job terminated (includes company closings, mergers, buyouts, grant or contract ended)
1 [ ] Yes 2 [ ] No

8. Retired
1 [ ] Yes 2 [ ] No

9. Other ? Specify: ____________________________________
1 [ ] Yes 2 [ ] No

PART C ? Other Work and Career Related Experience

C1.
During the past year, did you attend any professional society or association meetings or professional conferences? Include regional, national, or international meetings
1 [ ] Yes
2 [ ] No

C2.
To how many national international professional societies or associations do you currently belong?
Number _____ OR 0 [ ] NONE

C3.
During the past year, did you attend any WORK-RELATED workshops, seminars, or other work-related training activities?
Do NOT include college courses ? these will be discussed in PART D
Do NOT include professional meetings unless you attended a special training session conducted at the meeting/conference
1 [ ] Yes
2 [ ] No (SKIP to D1)

C4.
(IF YES) During the past year, in which of the following areas did you attend work-related workshops, seminars, or other work-related training activities?
Mark (X) Yes or No for each
1. Managing or supervisor training
1 [ ] Yes 2 [ ] No

2. Training in your occupational field
1 [ ] Yes 2 [ ] No

3. General professional training (e.g., public speaking, business writing)
1 [ ] Yes 2 [ ] No

4. Other work-related training ? specify: ________________________
1 [ ] Yes 2 [ ] No

C5.
For which of the following reasons did you attend training activities during the past year?
Mark (X) Yes or No for each
1. To facilitate a change in your occupational field
1 [ ] Yes 2 [ ] No

2. To gain FURTHER skills or knowledge in your occupational field
1 [ ] Yes 2 [ ] No

3. For licensure/certification
1 [ ] Yes 2 [ ] No

4. To increase opportunities for promotion/advancement/higher salary
1 [ ] Yes 2 [ ] No

5. To learn skills or knowledge needed for a recently acquired position
1 [ ] Yes 2 [ ] No

6. Required or expected by employer
1 [ ] Yes 2 [ ] No

7. Other ? Specify: ________________________________________
1 [ ] Yes 2 [ ] No

C6.
What was your most important reason for attending training activities? Enter number of appropriate reason from C5 above.
MOST IMPORTANT REASAON FOM C5 _____

PART D ? Background Information

D1.
Between April 1997 and April 1999, did you take any college or university courses or enroll in a college or university for other reasons, such as completing a Master's or PhD?
1 [ ] Yes
2 [ ] No (SKIP to D11, page 8)

D2.
(IF YES) In which college or university department were you primarily taking classes or doing research, etc. (e.g., English, chemistry)?
DEPARTMENT __________________________________

D3.
During that time, toward what degree or certificate, if any, were you (or are you) working?
0 [ ] Mark (X) this box if no specific degree or certificate and SKIP to D7

IF MORE THAN ONE APPLIES: Mark the highest level
Mark (X) ONLY One
1 [ ] Bachelor's degree
2 [ ] Post baccalaureate certificate
3 [ ] Master's degree (including MBA)
4 [ ] Post master's certificate
5 [ ] Doctorate (e.g., Ph.D., D.S.C., D.Sc., Ed.D.)
6 [ ] Other professional degree (e.g., JD, LLB, ThD, MD, DDS) ? Specify: ____________________
7 [ ] Other ? Specify: ____________________________________

D4.
Between April 1997 and April 1999, did you complete a degree or certificate?
1 [ ] Yes
2 [ ] No (SKIP to D7)

D4a.

(IF YES) What degree or certificate did you receive? Enter number of appropriate. TYPE OF DEGREE/CERTIFICATE received from D3 above.
TYPE OF DEGREE/CERTIFICATE FROM D3 ___

D5.
In what month and year was this degree or certificate awarded?
IF YOU COMPLETED MORE THAN ONE: Enter the date for the highest degree or certificate awarded
Month: ___ ___ Year: 19___ ___

D6.
From which academic institution did you receive this degree or certificate?
School Name: ______________________________
City/Town: _________________________________
State/Foreign Country; ________________________

D7.
What was your primary field of study during that time?
PRIMARY FIELD OF STUDY
_________________________________________________
_________________________________________________

D8.
Using the EDUCATION CODES (pages 12 ? 13), choose the code that BEST describes the field of study for this degree or certificate.
CODE ___ ___ ___
NOTE ? Education codes range from 601 to 995

D9.
For which of the following reasons were you taking classes or enrolled between April 1997 and April 1999?
Mark (X) Yes or No for each
1. To gain further education before beginning a career
1 [ ] Yes 2 [ ] No

2. To prepare for graduate school
1 [ ] Yes 2 [ ] No

3. To change your academic or occupational field
1 [ ] Yes 2 [ ] No

4. To gain FURTHER skills or knowledge in your academic or occupational field
1 [ ] Yes 2 [ ] No

5. For licensure/certification
1 [ ] Yes 2 [ ] No

6. To increase opportunities for promotion, advancement, or higher salary
1 [ ] Yes 2 [ ] No

7. Required or expected by employer
1 [ ] Yes 2 [ ] No

8. For leisure/personal interest
1 [ ] Yes 2 [ ] No

9. Other ? Specify: ____________________________
1 [ ] Yes 2 [ ] No

D10.
Were ANY of your school-related costs for taking college university courses during this time paid for by an employer?
1 [ ] Yes
2 [ ] No

D11.
As of the week of April 15, 1999 were you . . .
Mark (X) ONLY One
1 [ ] Married
2 [ ] Widowed (SKIP to D14)
3 [ ] Separated (SKIP to D14)
4 [ ] Divorced (SKIP to D14)
5 [ ] Never Married (SKIP to D14)

D12.
(IF MARRIED) During the week of April 15, was your spouse working for pay (or profit) at a full-time or part-time job?
1 [ ] Yes, full-time
2 [ ] Yes, part-time
3 [ ] No (SKIP to D14)

D13.
(IF YES) Did you spouse's duties on this job require the technical expertise of a bachelor's degree o higher in...
Mark (X) Yes or No for each
1. Engineering, computer science, math or the natural sciences
1 [ ] Yes 2 [ ] No

2. The social sciences
1 [ ] Yes 2 [ ] No

3. Some other field (e.g., health or business) ? Specify: ___________
1 [ ] Yes 2 [ ] No

D14.
During the week of April 15, did you have any children living with you as part of your family?
Only count children who lived with you at least 50 percent of the time
1 [ ] Yes (GO to D15)
2 [ ] No (SKIP to D16)

D15.
(IF YES) How many of these children living with you as pat of your family were...
IF NO CHILDREN IN A CATEGORY: Enter "0"
1. _____ Under age 2
2. _____ Aged 2-5
3. _____ Aged 6-11
4. _____ Aged 12-17
5. _____ Aged 18 or older

D16.
During the week of April 15, 1999, were you living in the United States or one of its territories, or were you living in another country?
1 [ ] United States or one of its territories
2 [ ] Another country

D17.
As of the week of April 15, 1999, were you a . . .
Mark (X) ONLY One
U.S. Citizen
1 [ ] Native born (SKIP to D19)
2 [ ] Naturalized (SKIP to D19)
Non-U.S. Citizen
3 [ ] With a Permanent U.S. Resident Visa
4 [ ] With a Temporary U.S. Resident Visa
5 [ ] Living outside the United States

D18.
(IF NON-U.S. CITIZEN) Of which country are you a citizen?
COUNTRY: ______________________________________________

D19.
What is your birthdate?
Month: ___ ___ Day: ___ ___ Year: 19___ ___

The next question is designed to help us better understand the career paths of individuals with different physical abilities.

D20.
What is the USUAL degree of difficulty you have with...
1. SEEING words or letters in ordinary newsprint (with glasses/contact lenses if you usually wear them)
1 [ ] None 2 [ ] Slight 3 [ ] Moderate 4 [ ] Severe 5 [ ] Unable to Do

2. HEARING what is normally said in conversation with another person (with hearing aid, if you usually wear one)
1 [ ] None 2 [ ] Slight 3 [ ] Moderate 4 [ ] Severe 5 [ ] Unable to Do

3. WALKING without human or mechanical assistance o using stairs
1 [ ] None 2 [ ] Slight 3 [ ] Moderate 4 [ ] Severe 5 [ ] Unable to Do

4. LIFTING or carrying something as heavy as 10 pounds, such as a bag groceries
1 [ ] None 2 [ ] Slight 3 [ ] Moderate 4 [ ] Severe 5 [ ] Unable to Do

D21.
0 [ ] Mark (X) this box if you answered "None" TO ALL ACTIVITIES in D20 and SKIP to D23


D22.
What is the earliest age at which you FIRST began experiencing ANY difficulties in ANY of these areas?
AGE ___ ___ OR 0 [ ] SINCE BIRTH

D23.
In case we need to clarify some of the information you have provided, please list a phone number (and an e-mail address if applicable) where you can be reached.
Daytime: ___ ___ ___-___ ___ ___-___ ___ ___ ___
Evening: ___ ___ ___-___ ___ ___-___ ___ ___ ___
E-mail address: ________________________________________

D24.
Since we are interested in how education and employment change over time, we may be recontacting you in 2001. To help us contact you, please provide the name, address, and telephone number of two people who are likely to know where you can be reached. DO NOT INCLUDE SOMEONE WHO LIVES IN YOUR HOUSEHOLD.
As with all the information provided in this questionnaire, complete confidentiality will be provided. These people will only be contacted if we have trouble contacting you in 2001.
____________________________________________
Name
____________________________________________
Number and Street
_________________________|_______|___________
City/Town State Zip Code
____________________________________________
Country (If outside U.S.)
|___|___|___|-|___|___|___|-|___|___|___|___|
Area Code Number
____________________________________________
Name
____________________________________________
Number and Street
_________________________|_______|___________
City/Town State Zip Code
____________________________________________
Country (If outside U.S.)
|___|___|___|-|___|___|___|-|___|___|___|___|
Area Code Number

D25.
PLEASE TURN TO THE BACK COVER FOR THE LAST QUESTION (D26).


D26.
Is the name and address information on the label the best one for us to use for any future mailings?
1 [ ] Yes
2 [ ] No - Please make name and address changes as needed below. Please print clearly.

Title: ____________ First name: ____________ Middle initial ____ Last name: _______________
Number and street: _________________ Apartment number: ____ City and town: _________ State: ___ ZIP Code: ____

THANK YOU FOR COMPLETING THE QUESTIONNAIRE
Please return the completed form in the envelope provided. If you lose the envelope and want another, call 1-800-523-3205. Our address is:

DIRECTOR
BUREAU OF THE CENSUS
1201 E 10TH ST
JEFFERSONVILLE IN 47132-0001