First Name:

Last Name:

Email Address:

Phone (optional):

Preferred method of contact: Preferred method of contact: Email Phone call Text message

Have you spoken English since childhood? Have you spoken English since childhood? Yes No

Where did you grow up? Where did you grow up? Rhode Island, in Providence or the surrounding areas Rhode Island, in another part of the state Born outside the area, moved to Rhode Island before age 7 Other

If you answered "another part of the state" above, please specify which

Have you ever lived outside of Rhode Island? Have you ever lived outside of Rhode Island? Yes, more than 4 years total between ages 7-18 Yes, more than 10 years total over the age of 18 Neither of the above

If you answered yes to either of the above, where did you live and at what ages?

Where do you currently live? Where do you currently live? Providence or the surrounding areas Another part of Rhode Island Massachusetts Other

Interview time/date preferences for the next six weeks. We can meet during business hours, in the evenings, or over the weekend:

Where would you prefer to be interviewed? We can travel within about an hour of Providence (including anywhere in Rhode Island). Since interviews are audio recorded, we just ask that meeting locations be relatively quiet (for example, offices, meeting rooms in libraries, etc. tend to work well). Where would you prefer to be interviewed? We can travel within about an hour of Providence (including anywhere in Rhode Island). Since interviews are audio recorded, we just ask that meeting locations be relatively quiet (for example, offices, meeting rooms in libraries, etc. tend to work well). Brown University campus (in Providence) Your home or office Other

If you selected "Other" above, please specify your preference.

What is your age? (Optional) What is your age? (Optional) 18-35 36-50 51-70 71+

What is your race/ethnicity (check all that apply)? (Optional) What is your race/ethnicity (check all that apply)? (Optional) African American/Black Asian American/Pacific Islander Hispanic/Latin@ Native American White Other

What is your occupation? (If retired, list your most recent occupation) (Optional):

How did you hear about us? How did you hear about us? Social media Printed flyer Email from a listserv Word of mouth Other

Any questions or comments?