Demographic Questionnaire
Section 1: Personal Information
1. Age:
☐ Under 18
☐ 18–24
☐ 25–34
☐ 35–44
☐ 45–54
☐ 55–64
☐ 65 or above
☐ Prefer not to say
2. Gender:
☐ Male
☐ Female
☐ Non-binary / Third gender
☐ Prefer to self-describe: ___________
☐ Prefer not to say
3. Marital Status:
☐ Single / Never married
☐ Married
☐ Widowed
☐ Divorced
☐ Separated
☐ Prefer not to say
Section 2: Socioeconomic Status
4. Highest Educational Qualification:
☐ No formal education
☐ Primary education
☐ Secondary education
☐ Undergraduate degree
☐ Postgraduate degree
☐ Doctorate or equivalent
☐ Prefer not to say
5. Employment Status:
☐ Employed full-time
☐ Employed part-time
☐ Self-employed
☐ Unemployed
☐ Student
☐ Retired
☐ Prefer not to say
6. Occupation (if employed/self-employed):
☐ Professional/Technical
☐ Administrative/Clerical
☐ Skilled trade
☐ Service industry
☐ Other: ___________
☐ Prefer not to say
7. Monthly Household Income:
☐ Less than ₹20,000
☐ ₹20,001–₹50,000
☐ ₹50,001–₹1,00,000
☐ ₹1,00,001–₹2,00,000
☐ Above ₹2,00,000
☐ Prefer not to say
8. Housing Status:
☐ Own home
☐ Rent home
☐ Other: ___________
☐ Prefer not to say
Section 3: Geographic Information
9. Current Residence:
City: ___________
State: ___________
Country: ___________
10. Area Type:
☐ Urban
☐ Semi-urban
☐ Rural
11. Place of Birth:
City: ___________
State: ___________
Country: ___________
12. Nationality:
☐ Indian
☐ Other: ___________
Section 4: Cultural & Social Background
13. Religion / Faith (optional):
☐ Hinduism
☐ Islam
☐ Christianity
☐ Sikhism
☐ Buddhism
☐ Jainism
☐ Other: ___________
☐ Prefer not to say
14. Ethnicity / Community (optional):
☐ ___________
☐ Prefer not to say
15. Language(s) Spoken at Home:
☐ Hindi
☐ English
☐ Other: ___________
Section 5: Household & Family Details
16. Household Size:
☐ 1 person
☐ 2–3 people
☐ 4–5 people
☐ More than 5 people
17. Number of Dependents:
☐ None
☐ 1–2
☐ 3–4
☐ More than 4
18. Type of Family:
☐ Nuclear
☐ Joint
☐ Extended
