1. How do you primarily identify yourself? Wiccan Witch Heathen Pagan Other

2. How do you worship? As part of a Coven or other working group As part of a larger community Solitary (alone)

3. Are you a member of a Wiccan/Pagan organization? No Yes, a Local Organization Yes, a National Organization Yes, a Multi-National Organization

4. What is your state or province of legal residence? Alabama Alaska Alberta American Samoa Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northern Mariana Islands Northwest Territories Nunavut Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Yukon Armed Forces Americas (except Canada) Armed Forces Africa Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific International / Other

5. Please enter your age range: Under 18 18 - 25 26 - 39 40 - 59 60 or over

6. Please enter your gender (or chosen gender expression): Female Male Other or Decline to State

7. What has been the religious/spiritual training of your children? No Children Your Faith Another Faith Multi - Faith None

8. What is the highest level of education you have completed? Current Student Some High School High School Trade School Some College Associates Degree Bachelors Degree Masters Degree PhD or Doctorate

9. What is your current field of employment? Full time Student Professional/Technical Trades Media/Arts Education Medical Military Service Industry Homemaker Retired Other

10. Do you have a military service record? Yes    No

11. Are you registered to vote? Yes    No