Thank you for taking the time to fill out this questionnaire. Required questions are indicated with an asterix ("*")

Demographic Information:
01	*	Age:
02	*	Gender:	Male Female
03	*	Country of Current Residence (Enter country code): US=United States CA=Canada UK=United Kingdom Complete listing of codes
04		If United States, please select state or territory:	Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington Washington, D.C. West Virginia Wisconcin Wyoming
05	*	The area where I live can be best described as:	a major city a city suburban a town rural

Family Background:
06	*	Number of grandparents living:	0 1 2 3 4 5 6 more than 6
07	*	Number of great grandparents living:	0 1 2 3 4 5 6 more than 6
08	*	Number of grandparents who live with me:	0 1 2 3 4 5 6 more than 6
09		If your answer to the previous question was at least 1, do either or both of your parents live with you?	All of the time Some of the time None of the time
10	*	Number of great grandparents who live with me:	0 1 2 3 4 5 6 more than 6
11		My family is best characterized as:	Nuclear Extended Joint

Education:
12	*	My school is a:	College or university Secondary School or High School Middle or Junior High School Primary or Elementary School
13	*	The number of students in my school is:	less than 100 100-500 500-1000 1000-2000 over 2000
14	*	Through a class I have taken at school, I have received at least 1 hour of instruction in the following areas (check all that apply):	Biology of Aging Psychological and social aspects of aging Creativity and Aging Contributions of the Elderly to Society Social, Legal or Political Responsibility to the Elderly Intergenerational Relations Cultural Views on Aging None of these

Contact With The Elderly:
15	*	On average, I have contact with the elderly that I am related to:	daily at least once a week several times a month once a month a few times a year rarely
16	*	On average, I have contact with the elderly that I am not related to:	daily at least once a week several times a month once a month a few times a year rarely

Attitudes Towards the Elderly:
17		I think that people become old when they reach the age of:	45 55 65 75 85 95 over 95
18	*	Most of the elderly I know are proud of their age:	Strongly Agree Agree Strongly Disagree Disagree
19	*	Most of the elderly I know like to spend time with people my age:	Strongly Agree Agree Strongly Disagree Disagree
20	*	Most of the elderly I know: (select up to 3 by holding down the Ctrl key while clicking):	are wise are honest are kind are helpful are fun to be with are friendly have a good sense of humor
21	*	How many of the elderly you know are set in their ways?	all most some few none
22	*	How many of the elderly you know keep in touch with what is happening the world?	all most some few none
23	*	How many of the elderly you know are physically active?	all most some few none
24	*	How many of the elderly you know are careful with money?	all most some few none
25	*	How many of the elderly you know enjoy life?	all most some few none
26	*	How many of the elderly you know are forgetful?	all most some few none
27	*	How many of the elderly you know have had their personalities change as their bodies age?	all most some few none
28	*	How many of the elderly you know often help others?	all most some few none
29	*	How many of the elderly you know have important things to say?	all most some few none

In the year 2030...
30	*	People in my country will live longer than people today:	Strongly Agree Agree Strongly Disagree Disagree
31	*	People in my country will live healthier lives than people today:	Strongly Agree Agree Strongly Disagree Disagree
32	*	Scientists will discover (check all that apply):	Ways to extend the life span A cure for cancer A cure for Alzheimer's Disease Treatments for many disorders of late life What regulates cell aging and death None of these things

When I am Old...
33		Compared with today, the importance of religion will be:	more less the same
34	*	Compared with today, the importance of family will be:	more less the same
35	*	Compared with today, the importance of friends will be:	more less the same
36	*	Compared with today, the importance of money will be:	more less the same
37	*	Compared with today, the amount of time I will spend with my family will be:	more less the same
38	*	Compared with today, the number of friends I will have will be:	more less the same

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