Ace Iq Questionnaire
Ace Iq Questionnaire
Ace Iq Questionnaire
0 DEMOGRAPHIC INFORMATION
0.1 Sex (Record Male / Female as observed) Male
[C1] Female
0.2 What is your date of birth? Day [ ][ ] Month [ ][ ] Year [ ][ ][ ][ ]
[C2] Unknown (Go to Q.C3)
0.3 How old are you? [ ][ ]
[C3]
0.4 What is your [insert relevant ethnic group / [Locally defined]
[C4] racial group / cultural group / others] [Locally defined]
background? [Locally defined]
Refused
0.5 What is the highest level of education you No formal schooling
[C5] have completed? Less than primary school
Primary school completed
Secondary/High school completed
College/University completed
Post graduate degree
Refused
0.6 Which of the following best describes your Government employee
[C6] main work status over the last 12 months? Non-government employee
Self-employed
Non-paid
Student
Homemaker
Retired
Unemployed (able to work)
Unemployed (unable to work)
Refused
0.7 What is your civic status? Married (Go to Q.M2)
[C7] Living as couple
Divorced or separated
Single
Widowed (Go to Q.M2)
Other
Refused
1 MARRIAGE
1.1 Have you ever been married? Yes
[M1] No (Go to Q.M5)
Refused
1.2 At what age were you first married? Age [ ][ ]
[M2] Refused
1.3 At the time of your first marriage did you Yes (Go to Q.M5)
[M3] yourself choose your husband/wife? No
Don't know / Not sure
Refused
1.4 At the time of your first marriage if you did not Yes
[M4] choose your husband/wife yourself, did you No
give your consent to the choice? Refused
1.5 If you are a mother or father what was your Age [ ][ ]
[M5] age when your first child was born? Not applicable
Refused