The Center for Relationship Enrichment
Student Relationships Assessment
ID# Please use last five digits of SS#
(Internationals: Last 5 digits of Student ID#)
Your Major:
Gender:
Male
Female
Age:
18 - 25
26 - 35
36 - 50
51 - 65
Over 65
Classification:
Freshman
Sophomore
Junior
Senior
Graduate Student
GPA:
3.6 to 4.0
3.0 to 3.5
2.6 to 2.9
2.0 to 2.5
Less than 2.0
Racial Identity:
Asian / Pacific-Islander
Black / African-American
Hispanic
Native-American / Indian
White / Euro-American
Other
Current Living Arrangement:
On campus
Off campus, live alone
Off campus, with parents
Off campus, with others
Off campus, with spouse
Religious Background:
Baptist
Catholic
Charismatic
Episcopal
Lutheran
Methodist
Presbyterian
Nondenominational
Other
Relationship Status of Parents:
Married & living together
Separated
Divorced, both single
Divorced, both remarried
Divorced, one single, one remarried
Widowed
Relationship Status:
Seriously Dating
Engaged
Single
Married
Separated
Divorced
In the past year, have you broken up with someone you were seriously dating?
Yes
No
How many people have you dated in the last year?
None
One
Two
Three
Four
Five or more
In the past year, have you changed your major?
Yes
No
DEMOGRAPHICS
1