How old are you? _____________ (years)
1.	What is your marital status? (Please check one):
□	Single
□	Partnered but not living together
□	Married
□	Common Law/Living Together
□	Separated/Divorced
□	Widowed
2.	What is the ethnic background you most identify with? (Please check any that apply):
□	Aboriginal (Inuit, Metis, North American Indian)
□	White (Caucasian)
□	Middle Eastern (e.g., Armenian, Egyptian, Iranian, Lebanese, Moroccan)
□	Black (e.g., African, Caribbean)
□	Asian (Chinese, Japanese, Korean, Filipino)
□	Hispanic
□	South Asian (Indian, Pakistani, Bangladeshi)
□	Other, please specify: _______________________
3.	Which of the following describes your residency status? (please check one):
□	Born in Canada
□	Immigrant
□	Refugee
□	Visitor
4.	What is the highest level of education that you have completed? (Please check one):
□	High school
□	College/university graduate
□	Post graduate/Professional degree
□	None of the above
5.	Which of the following describes your current residence (Please check one):
□	Own home/ condo/ duplex etc.
□	Renting
□	Living with family or friends
□	Living in a shelter
□	Homeless
□	Other_______________