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Use boxes at right to answer Y/N or with a quantity, etc. Estimate where necessary. You may omit responses where the questions are uncomfortable for personal reasons.
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How many pairs of shoes do you own? (include jogging shoes, sandals, etc.)
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How many cooking pots are in your kitchen? (include frying pans, casseroles, etc.)
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What is the ratio of occupants to rooms in your residence? (ex: 2:4 = two people occupy four rooms, such as 2 BR, one LR, K)
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How many light bulbs are plugged into sockets in your residence? (count even those in small-voltage nightlights)
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How many TVs, computer monitors, and laptop screens are there in your residence? (count the dead ones too)
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How many solid drinking cups are there in your residence? (glass, hard plastic, metal)
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Do you notice which fresh foods you buy are out of season and thus come from a distance?
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How many cars did your family own at one time when you lived at home?
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How many cars did your family own during the time you lived at home?
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Have you every pawned / cheaply sold a possession so you could eat / pay overdue rent?
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How many airline flights have you taken?
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What is the farthest distance you have been from home?
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How many people in your "group" - the people you hang out with - were born fewer than 20 miles from where you were born?
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How many farmers do you know?
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Do you know anyone who herds barnyard animals? (sheep, geese, etc.)
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How many people do you know who earn their living by unskilled / semi-skilled manual labor? (pick and shovel, small powered equipment)
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How many domestic servants have you seen in your life? (=in a nearby residence, not just in some large area and at a distance)
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How many domestic servants do you know personally?
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How many people do you know who are illiterate?
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How many children in your school(s) (K-12) died of non-violent illness or injury while you were there?
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How old was the youngest person whose death you experienced and how closely were you acquainted?
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How many human corpses have you seen at a distance of less than 50 feet?
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How many human corpses have you touched?
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Do you know anyone who has been punished corporally for a crime?
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What is the nearest you have been to armed enemy soldiers?
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Have you ever been quarantined?
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