(1) What is your age (Years)?

Age:

(2) What is your sex?

Male
Female
No Response

(3) How would you classify yourself?

Asian
Black
Caucasian/White
East Indian
Hispanic
Aboriginal
Middle Eastern
Other

(4) Do you consider yourself to be:

Straight or Heterosexual
Lesbian, Gay or Homosexual
Bisexual
Transgender
Don't Know

(5) Which best describes your current employment situation?

Full-time (more than 30 hours)
Part-time/casual job
Home maker
Full-time student
Retired
Not currently employed

(6) How would you rate your health?

1. Extremely Unhealthy 1 2 3 Somewhat Healthy 4 5 6 Extremely Healthy 7

(7) Do you have a criminal record? * Just a reminder that this questionnaire is completely anonymous.

Yes
No

If yes, what offence(s) were you convicted of?

Offence(s):