Adulthood - CMU
SC Adulthood Interview
The following are questions about your current circumstances. Some questions will ask you about the home you live in or about your current family.
1. How many people (NOT including yourself) live in your home? ____________
2. How many bedrooms (including guest bedrooms, bedrooms used as offices etc) are in the house or apartment which is your PRIMARY residence? ____________
____________have no primary residence
3. Which of the following best describes the highest level of educational you have completed?
o Didn’t Finish High School
o Didn’t Finish High School, but completed a technical/vocational program
o High School Graduate or GED (General Education Diploma)
o Completed High School and a technical/vocational program
o Less than 2 Years of College
o 2 Years of College or more/ including associate degree or equivalent
o College graduate (4 or 5 year program)
o Master’s degree (or other post-graduate training)
o Doctoral degree (PhD., MD, EdD, DVM, DDS, JD, etc)
Do you have firm plans for further education? Yes____ No____
If yes, what? __________________________
4. What is your current employment status? Check ALL that apply.
o Working full time for pay → number of hours per week ________
o Working part time for pay → number of hours per week ________
o Not currently employed, looking for work
o Retired
o Homemaker
o Disabled (not working because of permanent or temporary disability)
o Other (please specify): _____________
5. Which category best describes your yearly household income before taxes? Do not give the dollar amount, just give the category. Include all income received from employment, social security, support from children or other family, welfare, Aid to Families with Dependent Children (AFDC), bank interest, retirement accounts, rental property, investments, etc.
o Less than $5,000
o $5,000 - $9,999
o $10,000 - $14,999
o $15,000 - $19,999
o $20,000 - $29,999
o $30,000 - $39,999
o $40,000 - $49,999
o $50,000 - $59,999
o $60-000 - $74,999
o $75,000 - $99,999
o $100,000 - $124,999
o $125,000 - $149,999
o $150,000 or more
6. Do you OWN your own home now (includes paying a mortgage)?
Yes____ No____
7. Do you OWN a working motor vehicle (car, truck, van, SUV) now?
Yes____ No____ If yes, how many do you own? _____
8. During the last year, did you take an out-of-town vacation?
Yes____ No____
9. Do you have a daily newspaper delivered to your home?
Yes____ No____
10. During the last year, did you have a dental check-up?
Yes____ No____
11. Compared to others your age, would you say your health is:
___ Excellent ___ Very Good ___Good ___Fair ___Poor
12. Approximately how many books do your read a year?
___Never ____1-2 per year ___ 3-4 per year 4 or more____
For the following, if you cannot remember, please make you BEST estimate.
13. How old is your MOTHER? _____
If your mother passed away, how old was she when she died?__________
What year did she die? __________
Don’t know any of the above __________
14. How old is your FATHER? __________
If your father passed away, how old was he when he died? __________
What year did he die? __________
Don’t know any of the above __________
Community Ladder
INSTRUCTIONS:
Think of this ladder as representing a person’s status within his or her community. By community we mean friends, family, neighbors, and coworkers.
At the top of this ladder are the people who have the highest standing in their community and are best thought of by other community members. At the bottom are the people who have the lowest standing in their community. The higher up you are on this ladder, the closer you are to the people at the very top and the lower you are, the closer you are to the people at the very bottom.
Where would you place yourself on this ladder? Please, place an “X” on the rung where you think you stand at this time in your life, relative to other people in your community.
For example:
INSTRUCTIONS:
Think of this ladder as representing where people stand in the United States. At the top of the ladder are the people who have the most money, most education, and most respected jobs. At the bottom are the people who have the least money, least education, and least respected jobs or no job. The higher up you are on this ladder, the closer you are to the people at the very top, and the lower you are, the closer you are to the people at the very bottom.
Where would you place yourself on this ladder? Please, place an “X” on the rung where you think you stand at this time in your life, relative to other people in the United States.
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