1. If an accredited two year community college or four year university level space colonization education program were available would you be interested in attending either?

 Yes No

2. If an accredited two year community college or four year university level space colonization education program were available which also led to a traditional technical or professional college degree, would you be interested in attending either?

 Yes No

3. If the space colonization education program required a simulated but realistic space mission how many years would you be willing to commit to your space mission education? (meaning being away from earth except for electronic communication.)

Less than 1 Year 1 year 2 years 3 years 4 years More than 4 years.

4. If you are married and have a family and your family could be on the simulated space mission with you and continued their own education, how many years would you devote to your simulated space mission education? 

1 Year 2 Years 3 Years 4 Years 0 Years

5. Which of the following simulated space missions would be of most interest to you?

A base on the Moon. A base on Mars. A base orbiting Jupiter. A base orbiting Saturn.

6. If a typical traditional college program's tuition, room and board cost you $12,000 per year how much would you expect to pay per year for tuition, room and board, for an education program based on a simulated space colonization mission? 

$12,000 - $15,999 per year $16,000 - $19,999 per year $20,000 - $23,999 per year $24,000 - $ 28,000 per year

7. If a four year space colonization mission education program placed you on a list of potential candidates for NASA astronaut training how much would you be willing to pay per year for tuition, room and board? 

$12,000 - $15,999 per year $16,000 - $19,999 per year $20,000 - $23,999 per year $24,000 - $28,000 per year More than $28,000 per year

7. General Information :

Age:
Gender:	Male Female
Education Completed:	Jr.High before High School High School Community College 4 year  degree Masters degree Doctors Please Select
Profession:
Annual Income:	0$ - $12,000 per year $16,000 - $20,000 per year $20,000 - $30,000 per year $30,000 - $40,000 per year $40,000  - $ 50,000 per year $50,000 -  $70,000 per year $70,000 - $100,000.00 $100,000 or more
Married (Partner):	Yes I am Married or have a Partner No I am not Married or have a partner
Number of Children:	0 1 2 3 4 5 6 7 or more
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