Married (or dating) with Children

How long have you known your current partner (please indicate months or years)?

How long have you been together as a couple with your current partner?

What is your current living arrangement?

Living together
Living separately but spending most nights together
Living separately but frequently spending nights together
Living separately but occassionally spending nights together
Living separately and rarely or never spending nights together
Living in different cities - long distance relationship

Please indicate the degree of happiness, all things considered, of your relationship.
Are you currently in couples counseling?

Have you ever been in couples counseling with your current partner?

How many biological or adopted children do you have with your current partner?
How many biological children (if any) do you have with previous partners?
How many (if any) biological children from previous partners are currently living with you at least 3 days a week?
How many biological children (if any) does your partner have with previous partners?
How many (if any) of your partner's children from previous relationships are currently living with you at least 3 days a week?

Do you pay child support?

IF SO, what is your monthly child support payment:

Does your partner pay child support?

IF SO, what is your partner's monthly child support payment:

How old are you?
How old is your partner?

	male	female
What is your gender?
What is your partner's gender?

	Caucasian	African American	Latino Hispanic	Asian Pacific Islander	Native American	Middle Eastern	Other
What is your racial / ethnic background?
What is your partner's racial / ethnic background?

	Less than 10th grade	10th grade	11th grade	HS diploma	Some College or trade school	AA degree or trade school certif.	BA/BS degree	MA/ MS degree	Law degree	PhD/ PsyD	DDS	MD
Your highest degree:
Your partners?

	No	Part-time	Full-time (about 40 hrs per week)	More than 60 hours per week
Are you currently in school?
Is your partner in school?
Are you currently working?
Is your partner working?

What is your MONTHLY INCOME (before taxes)?
What is your partner's MONTHLY INCOME (if known)?

How did you find out about this survey?
Please try to be specific with your answer For example:	email from a friend Google search www.theNest.com www.CanadianBride.com

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