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Word version of Demographic Questionnaire

What is your gender?

__ Male

__ Female

What is your age?

__ 16 - 18 years

__ 19 - 24 years

__ 25 - 30 years

__ 31 - 35 years

__ 35 - 40 years

__ 41 - 50 years

__ 51 - 60 years

__ Over 60 years

What is your role on campus?

__ Faculty

__ Student

__ GSI/Grad student/PhD candidate

__ Staff

What is your job title?

___________________________________________

Do you do any of the following online and if so how often?

Check email:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Use instant messaging:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Shop online:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Use online banking:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Internet research for classes:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Take classes online:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Social Networking:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Do you upload files on the web and if so how often?

Pictures to share with others:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Media to share with others:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Documents to course website:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Documents to social networking site:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Attach file in email:

All the time | A few times a week | A few times a month | Hardly Ever | Never

Do you own a personal computer and if so, what kind?

______________________________________________

What is your comfort level with technology?

Uncomfortable | Not very comfortable | Somewhat Comfortable | Comfortable | Very Comfortable

If you use adaptive technologies, please also answer the following:

How would you describe your adaptive technology skills?

Beginner | Average | Above average | Expert

What types of adaptive technology do you use?:

Screen reader:

Name:__________________________________ Version:_______

Screen enlarger:

Name:__________________________________ Version:_______

Browser:

Name:__________________________________ Version:_______

Approximately when did you last upgrade your adaptive technology? ___________________

(Screen reader users) Do you customize your settings or use the default level on your software?

(If customize) What do you customize? ____________________________________________

(If use default) What level of default do you use?

Beginner | Moderate | Advanced