Questionnaire

Page 1

A. Biographical Information 1.

Which age group do you fall into?

1 2 3 4 5 6 8

Younger than 13 13-19 20-29 30-39 40-59 60-69 70 and older

2.

Please select your gender

1 2

Female Male

3.

In which province do you live

1 2 3 4 5 6 7 8 9

Gauteng Limpopo Eastern Cape Western Cape Northern Cape KwaZulu-Natal North West Province Mpumalanga Free State

4.

At home I mostly speak

1 2 3 4 5 6 7 8 9 10 11 12

Afrikaans English Ndebele Northern Sotho Sotho Swati Tsonga Tswana Venda Xhosa Zulu Other, please specify

5.

My marital status is

1 2

Married Unmarried

1


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