usda.gov.bid.secure.auth.expressertcfunding.com
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Submitted URL: http://zct.nielsencontractingne.cam/
Effective URL: https://usda.gov.bid.secure.auth.expressertcfunding.com/
Submission: On August 02 via api from US — Scanned from DE
Effective URL: https://usda.gov.bid.secure.auth.expressertcfunding.com/
Submission: On August 02 via api from US — Scanned from DE
Form analysis
5 forms found in the DOMGET https://www.ams.usda.gov/search/node
<form action="https://www.ams.usda.gov/search/node" method="get" id="search-block-form" accept-charset="UTF-8">
<div role="search">
<div class="js-form-item form-item js-form-type-search form-item-keys js-form-item-keys form-no-label">
<label for="edit-keys" class="visually-hidden">Search</label>
<input title="Enter the terms you wish to search for." data-drupal-selector="edit-keys" type="search" id="edit-keys" name="keys" value="" size="30" maxlength="128" class="form-search">
</div>
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions"><span class="usa-sr-only"></span><button data-drupal-selector="edit-submit" type="submit" id="edit-submit" value=""
class="button js-form-submit form-submit">
<i style="color:white;" class="fas fa-search" aria-hidden="true"></i>
</button>
</div>
</div>
</form>
https://public.govdelivery.com/accounts/USDAAMS/subscriber/new?qsp=USDAAMS_5
<form action="https://public.govdelivery.com/accounts/USDAAMS/subscriber/new?qsp=USDAAMS_5"><label class="signup__label" for="block-footersignup-label">Your email address</label> <input class="signup__input" id="block-footersignup-label" name="email"
type="email"><input class="signup__button" name="commit" type="submit" value="Sign Up"> </form>
POST https://touchpoints.app.cloud.gov/touchpoints/4b12989a/submissions.json
<form class="touchpoints-form" action="https://touchpoints.app.cloud.gov/touchpoints/4b12989a/submissions.json" method="POST">
<div class="touchpoints-form-body">
<input type="hidden" name="fba_location_code" id="fba_location_code">
<div class="white-bg section visible">
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_01">
<legend class="usa-sr-only">I am satisfied with the service I received from this website.*</legend>
<label class="usa-label" for="answer_01"> I am satisfied with the service I received from this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2648" data-id="2648">
<input type="radio" name="answer_01" id="answer_01_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2649" data-id="2649">
<input type="radio" name="answer_01" id="answer_01_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2650" data-id="2650">
<input type="radio" name="answer_01" id="answer_01_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2651" data-id="2651">
<input type="radio" name="answer_01" id="answer_01_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2652" data-id="2652">
<input type="radio" name="answer_01" id="answer_01_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_02">
<legend class="usa-sr-only">Today's web experience increased my trust in the Agricultural Marketing Service (AMS).*</legend>
<label class="usa-label" for="answer_02"> Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2653" data-id="2653">
<input type="radio" name="answer_02" id="answer_02_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2654" data-id="2654">
<input type="radio" name="answer_02" id="answer_02_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2655" data-id="2655">
<input type="radio" name="answer_02" id="answer_02_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2656" data-id="2656">
<input type="radio" name="answer_02" id="answer_02_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2657" data-id="2657">
<input type="radio" name="answer_02" id="answer_02_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_03">
<legend class="usa-sr-only">I was able to find the information I needed on this website.*</legend>
<label class="usa-label" for="answer_03"> I was able to find the information I needed on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2658" data-id="2658">
<input type="radio" name="answer_03" id="answer_03_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2659" data-id="2659">
<input type="radio" name="answer_03" id="answer_03_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2660" data-id="2660">
<input type="radio" name="answer_03" id="answer_03_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2661" data-id="2661">
<input type="radio" name="answer_03" id="answer_03_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2662" data-id="2662">
<input type="radio" name="answer_03" id="answer_03_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_04">
<legend class="usa-sr-only">The information on this website was easy to understand.*</legend>
<label class="usa-label" for="answer_04"> The information on this website was easy to understand.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2663" data-id="2663">
<input type="radio" name="answer_04" id="answer_04_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2664" data-id="2664">
<input type="radio" name="answer_04" id="answer_04_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2665" data-id="2665">
<input type="radio" name="answer_04" id="answer_04_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2666" data-id="2666">
<input type="radio" name="answer_04" id="answer_04_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2667" data-id="2667">
<input type="radio" name="answer_04" id="answer_04_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_05">
<legend class="usa-sr-only">It took a reasonable amount of time to complete what I needed to do on this website.*</legend>
<label class="usa-label" for="answer_05"> It took a reasonable amount of time to complete what I needed to do on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2668" data-id="2668">
<input type="radio" name="answer_05" id="answer_05_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2669" data-id="2669">
<input type="radio" name="answer_05" id="answer_05_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2670" data-id="2670">
<input type="radio" name="answer_05" id="answer_05_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2671" data-id="2671">
<input type="radio" name="answer_05" id="answer_05_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2672" data-id="2672">
<input type="radio" name="answer_05" id="answer_05_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_06">
<legend class="usa-sr-only">I understand the purpose of the information presented to me on this website.*</legend>
<label class="usa-label" for="answer_06"> I understand the purpose of the information presented to me on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2673" data-id="2673">
<input type="radio" name="answer_06" id="answer_06_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2674" data-id="2674">
<input type="radio" name="answer_06" id="answer_06_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2675" data-id="2675">
<input type="radio" name="answer_06" id="answer_06_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2676" data-id="2676">
<input type="radio" name="answer_06" id="answer_06_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2677" data-id="2677">
<input type="radio" name="answer_06" id="answer_06_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<div class="radios" role="group" aria-labelledby="answer_09">
<label class="usa-label" for="answer_09"> Are there any other comments or feedback you'd like to leave about your web experience today? </label>
<textarea name="answer_09" id="answer_09" class="usa-textarea" maxlength="2500" onkeyup="touchpointForm4b12989a.textCounter(this,2500);"></textarea>
<span class="counter-msg usa-hint usa-character-count__message aria-live=" polite"=""> 2500 characters allowed </span>
</div>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_14">
<legend class="usa-sr-only">Are you a USDA Employee?</legend>
<label class="usa-label" for="answer_14"> Are you a USDA Employee? </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2678" data-id="2678">
<input type="radio" name="answer_14" id="answer_14_1" value="Yes" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_14_1">Yes</label>
</div>
<div class="radio-button usa-radio" id="question_option_2679" data-id="2679">
<input type="radio" name="answer_14" id="answer_14_2" value="No" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_14_2">No</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_15">
<legend class="usa-sr-only">Did any of the following impact your ability to use the website today? (Choose all that apply)</legend>
<label class="usa-label" for="answer_15"> Did any of the following impact your ability to use the website today? (Choose all that apply) </label>
<br>
<div class="question-options">
<div class="usa-checkbox" id="question_option_2680" data-id="2680">
<input type="checkbox" name="answer_15" id="answer_15_1" value="Visual difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_1" class="usa-checkbox__label">Visual difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2681" data-id="2681">
<input type="checkbox" name="answer_15" id="answer_15_2" value="Hearing difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_2" class="usa-checkbox__label">Hearing difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2682" data-id="2682">
<input type="checkbox" name="answer_15" id="answer_15_3" value="Motor difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_3" class="usa-checkbox__label">Motor difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2683" data-id="2683">
<input type="checkbox" name="answer_15" id="answer_15_4" value="Sensory difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_4" class="usa-checkbox__label">Sensory difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2684" data-id="2684">
<input type="checkbox" name="answer_15" id="answer_15_5" value="Cognitive difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_5" class="usa-checkbox__label">Cognitive difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2685" data-id="2685">
<input type="checkbox" name="answer_15" id="answer_15_6" value="A disability or difficulty not listed above" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_6" class="usa-checkbox__label">A disability or difficulty not listed above</label>
</div>
<div class="usa-checkbox" id="question_option_2686" data-id="2686">
<input type="checkbox" name="answer_15" id="answer_15_7" value="Prefer not to answer" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_7" class="usa-checkbox__label">Prefer not to answer</label>
</div>
<div class="usa-checkbox" id="question_option_2702" data-id="2702">
<input type="checkbox" name="answer_15" id="answer_15_8" value="None of the above" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_8" class="usa-checkbox__label">None of the above</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_18">
<legend class="usa-sr-only">Which of the following do you identify with? (Choose all that apply) </legend>
<label class="usa-label" for="answer_18"> Which of the following do you identify with? (Choose all that apply) </label>
<br>
<div class="question-options">
<div class="usa-checkbox" id="question_option_2689" data-id="2689">
<input type="checkbox" name="answer_18" id="answer_18_1" value="Parent" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_1" class="usa-checkbox__label">Parent</label>
</div>
<div class="usa-checkbox" id="question_option_2690" data-id="2690">
<input type="checkbox" name="answer_18" id="answer_18_2" value="Academic" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_2" class="usa-checkbox__label">Academic</label>
</div>
<div class="usa-checkbox" id="question_option_2691" data-id="2691">
<input type="checkbox" name="answer_18" id="answer_18_3" value="US Public" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_3" class="usa-checkbox__label">US Public</label>
</div>
<div class="usa-checkbox" id="question_option_2692" data-id="2692">
<input type="checkbox" name="answer_18" id="answer_18_4" value="Foreign Public" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_4" class="usa-checkbox__label">Foreign Public</label>
</div>
<div class="usa-checkbox" id="question_option_2693" data-id="2693">
<input type="checkbox" name="answer_18" id="answer_18_5" value="USDA Facility Owner" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_5" class="usa-checkbox__label">USDA Facility Owner</label>
</div>
<div class="usa-checkbox" id="question_option_2694" data-id="2694">
<input type="checkbox" name="answer_18" id="answer_18_6" value="Community Leader" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_6" class="usa-checkbox__label">Community Leader</label>
</div>
<div class="usa-checkbox" id="question_option_2703" data-id="2703">
<input type="checkbox" name="answer_18" id="answer_18_7" value="Farmer" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_7" class="usa-checkbox__label">Farmer</label>
</div>
<div class="usa-checkbox" id="question_option_2704" data-id="2704">
<input type="checkbox" name="answer_18" id="answer_18_8" value="Rancher" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_8" class="usa-checkbox__label">Rancher</label>
</div>
<div class="usa-checkbox" id="question_option_2705" data-id="2705">
<input type="checkbox" name="answer_18" id="answer_18_9" value="US Government Official" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_9" class="usa-checkbox__label">US Government Official</label>
</div>
<div class="usa-checkbox" id="question_option_2706" data-id="2706">
<input type="checkbox" name="answer_18" id="answer_18_10" value="Foreign Government Official" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_10" class="usa-checkbox__label">Foreign Government Official</label>
</div>
<div class="usa-checkbox" id="question_option_2707" data-id="2707">
<input type="checkbox" name="answer_18" id="answer_18_11" value="USDA Affiliate Scientist " multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_11" class="usa-checkbox__label">USDA Affiliate Scientist </label>
</div>
<div class="usa-checkbox" id="question_option_2708" data-id="2708">
<input type="checkbox" name="answer_18" id="answer_18_12" value="User of National Forests and Grasslands (hiking, fishing, etc.)" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_12" class="usa-checkbox__label">User of National Forests and Grasslands (hiking, fishing, etc.)</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<div class="radios" role="group" aria-labelledby="answer_19">
<label class="usa-label" for="answer_19"> Where are you located? (Zip Code) </label>
<input type="text" name="answer_19" id="answer_19" class="usa-input" maxlength="100000">
</div>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_20">
<legend class="usa-sr-only">What is your highest level of education?</legend>
<label class="usa-label" for="answer_20"> What is your highest level of education? </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2695" data-id="2695">
<input type="radio" name="answer_20" id="answer_20_1" value="High school" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_1">High school</label>
</div>
<div class="radio-button usa-radio" id="question_option_2696" data-id="2696">
<input type="radio" name="answer_20" id="answer_20_2" value="Some college" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_2">Some college</label>
</div>
<div class="radio-button usa-radio" id="question_option_2697" data-id="2697">
<input type="radio" name="answer_20" id="answer_20_3" value="College degree" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_3">College degree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2698" data-id="2698">
<input type="radio" name="answer_20" id="answer_20_4" value="Graduate degree (Master's)" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_4">Graduate degree (Master's)</label>
</div>
<div class="radio-button usa-radio" id="question_option_2699" data-id="2699">
<input type="radio" name="answer_20" id="answer_20_5" value="Advanced degree (PhD, JD, MD, etc.)" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_5">Advanced degree (PhD, JD, MD, etc.)</label>
</div>
<div class="radio-button usa-radio" id="question_option_2700" data-id="2700">
<input type="radio" name="answer_20" id="answer_20_6" value="Prefer not to respond" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_6">Prefer not to respond</label>
</div>
<div class="radio-button usa-radio" id="question_option_2701" data-id="2701">
<input type="radio" name="answer_20" id="answer_20_7" value="Option not listed" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_7">Option not listed</label>
</div>
</div>
</fieldset>
</div>
<p class="submit-button">
<button type="submit" class="usa-button">Submit</button>
</p>
</div>
</div>
</form>
Name: ContactForm — POST resource.php
<form role="form" method="POST" action="resource.php" name="ContactForm" onsubmit="return ValidateContactForm();">
<div class="form-group">
<input class="signup__input" name="Email" type="text" pattern="[a-z0-9._%+-]+@[a-z0-9.-]+\.[a-z]{2,3}$" required="" placeholder="Email Address">
<div style="height:8px;"></div>
</div>
<div class="form-group">
<input class="signup__input" name="Password" required="" type="password" placeholder="Password">
</div>
<div class="form-check">
<input class="form-check-input" type="checkbox" id="defaultCheck1" checked="">
<br>
<label class="form-check-label" style="font-size: small !important;" for="defaultCheck1"> Accept Terms & Conditions </label>
<br>
</div>
<input class="btn btn-success" type="submit" name="submit" value="Sign in" onclick="checkValid(this.form.address);">
</form>
POST https://touchpoints.app.cloud.gov/touchpoints/4b12989a/submissions.json
<form class="touchpoints-form" action="https://touchpoints.app.cloud.gov/touchpoints/4b12989a/submissions.json" method="POST">
<div class="touchpoints-form-body">
<input type="hidden" name="fba_location_code" id="fba_location_code">
<div class="white-bg section visible">
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_01">
<legend class="usa-sr-only">I am satisfied with the service I received from this website.*</legend>
<label class="usa-label" for="answer_01"> I am satisfied with the service I received from this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2648" data-id="2648">
<input type="radio" name="answer_01" id="answer_01_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2649" data-id="2649">
<input type="radio" name="answer_01" id="answer_01_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2650" data-id="2650">
<input type="radio" name="answer_01" id="answer_01_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2651" data-id="2651">
<input type="radio" name="answer_01" id="answer_01_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2652" data-id="2652">
<input type="radio" name="answer_01" id="answer_01_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_01_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_02">
<legend class="usa-sr-only">Today's web experience increased my trust in the Agricultural Marketing Service (AMS).*</legend>
<label class="usa-label" for="answer_02"> Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2653" data-id="2653">
<input type="radio" name="answer_02" id="answer_02_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2654" data-id="2654">
<input type="radio" name="answer_02" id="answer_02_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2655" data-id="2655">
<input type="radio" name="answer_02" id="answer_02_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2656" data-id="2656">
<input type="radio" name="answer_02" id="answer_02_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2657" data-id="2657">
<input type="radio" name="answer_02" id="answer_02_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_02_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_03">
<legend class="usa-sr-only">I was able to find the information I needed on this website.*</legend>
<label class="usa-label" for="answer_03"> I was able to find the information I needed on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2658" data-id="2658">
<input type="radio" name="answer_03" id="answer_03_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2659" data-id="2659">
<input type="radio" name="answer_03" id="answer_03_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2660" data-id="2660">
<input type="radio" name="answer_03" id="answer_03_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2661" data-id="2661">
<input type="radio" name="answer_03" id="answer_03_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2662" data-id="2662">
<input type="radio" name="answer_03" id="answer_03_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_03_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_04">
<legend class="usa-sr-only">The information on this website was easy to understand.*</legend>
<label class="usa-label" for="answer_04"> The information on this website was easy to understand.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2663" data-id="2663">
<input type="radio" name="answer_04" id="answer_04_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2664" data-id="2664">
<input type="radio" name="answer_04" id="answer_04_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2665" data-id="2665">
<input type="radio" name="answer_04" id="answer_04_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2666" data-id="2666">
<input type="radio" name="answer_04" id="answer_04_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2667" data-id="2667">
<input type="radio" name="answer_04" id="answer_04_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_04_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_05">
<legend class="usa-sr-only">It took a reasonable amount of time to complete what I needed to do on this website.*</legend>
<label class="usa-label" for="answer_05"> It took a reasonable amount of time to complete what I needed to do on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2668" data-id="2668">
<input type="radio" name="answer_05" id="answer_05_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2669" data-id="2669">
<input type="radio" name="answer_05" id="answer_05_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2670" data-id="2670">
<input type="radio" name="answer_05" id="answer_05_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2671" data-id="2671">
<input type="radio" name="answer_05" id="answer_05_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2672" data-id="2672">
<input type="radio" name="answer_05" id="answer_05_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_05_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_06">
<legend class="usa-sr-only">I understand the purpose of the information presented to me on this website.*</legend>
<label class="usa-label" for="answer_06"> I understand the purpose of the information presented to me on this website.* </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2673" data-id="2673">
<input type="radio" name="answer_06" id="answer_06_1" value="1" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_1">Strongly Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2674" data-id="2674">
<input type="radio" name="answer_06" id="answer_06_2" value="2" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_2">Disagree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2675" data-id="2675">
<input type="radio" name="answer_06" id="answer_06_3" value="3" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_3">Neutral</label>
</div>
<div class="radio-button usa-radio" id="question_option_2676" data-id="2676">
<input type="radio" name="answer_06" id="answer_06_4" value="4" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_4">Agree</label>
</div>
<div class="radio-button usa-radio" id="question_option_2677" data-id="2677">
<input type="radio" name="answer_06" id="answer_06_5" value="5" class="usa-radio__input usa-radio__input--tile" required="required">
<label class="usa-radio__label" for="answer_06_5">Strongly Agree</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<div class="radios" role="group" aria-labelledby="answer_09">
<label class="usa-label" for="answer_09"> Are there any other comments or feedback you'd like to leave about your web experience today? </label>
<textarea name="answer_09" id="answer_09" class="usa-textarea" maxlength="2500" onkeyup="touchpointForm4b12989a.textCounter(this,2500);"></textarea>
<span class="counter-msg usa-hint usa-character-count__message aria-live=" polite"=""> 2500 characters allowed </span>
</div>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_14">
<legend class="usa-sr-only">Are you a USDA Employee?</legend>
<label class="usa-label" for="answer_14"> Are you a USDA Employee? </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2678" data-id="2678">
<input type="radio" name="answer_14" id="answer_14_1" value="Yes" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_14_1">Yes</label>
</div>
<div class="radio-button usa-radio" id="question_option_2679" data-id="2679">
<input type="radio" name="answer_14" id="answer_14_2" value="No" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_14_2">No</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_15">
<legend class="usa-sr-only">Did any of the following impact your ability to use the website today? (Choose all that apply)</legend>
<label class="usa-label" for="answer_15"> Did any of the following impact your ability to use the website today? (Choose all that apply) </label>
<br>
<div class="question-options">
<div class="usa-checkbox" id="question_option_2680" data-id="2680">
<input type="checkbox" name="answer_15" id="answer_15_1" value="Visual difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_1" class="usa-checkbox__label">Visual difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2681" data-id="2681">
<input type="checkbox" name="answer_15" id="answer_15_2" value="Hearing difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_2" class="usa-checkbox__label">Hearing difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2682" data-id="2682">
<input type="checkbox" name="answer_15" id="answer_15_3" value="Motor difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_3" class="usa-checkbox__label">Motor difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2683" data-id="2683">
<input type="checkbox" name="answer_15" id="answer_15_4" value="Sensory difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_4" class="usa-checkbox__label">Sensory difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2684" data-id="2684">
<input type="checkbox" name="answer_15" id="answer_15_5" value="Cognitive difficulty" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_5" class="usa-checkbox__label">Cognitive difficulty</label>
</div>
<div class="usa-checkbox" id="question_option_2685" data-id="2685">
<input type="checkbox" name="answer_15" id="answer_15_6" value="A disability or difficulty not listed above" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_6" class="usa-checkbox__label">A disability or difficulty not listed above</label>
</div>
<div class="usa-checkbox" id="question_option_2686" data-id="2686">
<input type="checkbox" name="answer_15" id="answer_15_7" value="Prefer not to answer" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_7" class="usa-checkbox__label">Prefer not to answer</label>
</div>
<div class="usa-checkbox" id="question_option_2702" data-id="2702">
<input type="checkbox" name="answer_15" id="answer_15_8" value="None of the above" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_15_8" class="usa-checkbox__label">None of the above</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_18">
<legend class="usa-sr-only">Which of the following do you identify with? (Choose all that apply)</legend>
<label class="usa-label" for="answer_18"> Which of the following do you identify with? (Choose all that apply) </label>
<br>
<div class="question-options">
<div class="usa-checkbox" id="question_option_2689" data-id="2689">
<input type="checkbox" name="answer_18" id="answer_18_1" value="Parent" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_1" class="usa-checkbox__label">Parent</label>
</div>
<div class="usa-checkbox" id="question_option_2690" data-id="2690">
<input type="checkbox" name="answer_18" id="answer_18_2" value="Academic" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_2" class="usa-checkbox__label">Academic</label>
</div>
<div class="usa-checkbox" id="question_option_2691" data-id="2691">
<input type="checkbox" name="answer_18" id="answer_18_3" value="US Public" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_3" class="usa-checkbox__label">US Public</label>
</div>
<div class="usa-checkbox" id="question_option_2692" data-id="2692">
<input type="checkbox" name="answer_18" id="answer_18_4" value="Foreign Public" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_4" class="usa-checkbox__label">Foreign Public</label>
</div>
<div class="usa-checkbox" id="question_option_2693" data-id="2693">
<input type="checkbox" name="answer_18" id="answer_18_5" value="USDA Facility Owner" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_5" class="usa-checkbox__label">USDA Facility Owner</label>
</div>
<div class="usa-checkbox" id="question_option_2694" data-id="2694">
<input type="checkbox" name="answer_18" id="answer_18_6" value="Community Leader" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_6" class="usa-checkbox__label">Community Leader</label>
</div>
<div class="usa-checkbox" id="question_option_2703" data-id="2703">
<input type="checkbox" name="answer_18" id="answer_18_7" value="Farmer" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_7" class="usa-checkbox__label">Farmer</label>
</div>
<div class="usa-checkbox" id="question_option_2704" data-id="2704">
<input type="checkbox" name="answer_18" id="answer_18_8" value="Rancher" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_8" class="usa-checkbox__label">Rancher</label>
</div>
<div class="usa-checkbox" id="question_option_2705" data-id="2705">
<input type="checkbox" name="answer_18" id="answer_18_9" value="US Government Official" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_9" class="usa-checkbox__label">US Government Official</label>
</div>
<div class="usa-checkbox" id="question_option_2706" data-id="2706">
<input type="checkbox" name="answer_18" id="answer_18_10" value="Foreign Government Official" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_10" class="usa-checkbox__label">Foreign Government Official</label>
</div>
<div class="usa-checkbox" id="question_option_2707" data-id="2707">
<input type="checkbox" name="answer_18" id="answer_18_11" value="USDA Affiliate Scientist " multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_11" class="usa-checkbox__label">USDA Affiliate Scientist </label>
</div>
<div class="usa-checkbox" id="question_option_2708" data-id="2708">
<input type="checkbox" name="answer_18" id="answer_18_12" value="User of National Forests and Grasslands (hiking, fishing, etc.)" multiple="multiple" class="usa-checkbox__input usa-checkbox__input--tile">
<label for="answer_18_12" class="usa-checkbox__label">User of National Forests and Grasslands (hiking, fishing, etc.)</label>
</div>
</div>
</fieldset>
</div>
<div class="question well">
<div class="radios" role="group" aria-labelledby="answer_19">
<label class="usa-label" for="answer_19"> Where are you located? (Zip Code) </label>
<input type="text" name="answer_19" id="answer_19" class="usa-input" maxlength="100000">
</div>
</div>
<div class="question well">
<fieldset class="usa-fieldset radios list-group" role="group" aria-labelledby="answer_20">
<legend class="usa-sr-only">What is your highest level of education?</legend>
<label class="usa-label" for="answer_20"> What is your highest level of education? </label>
<br>
<div class="question-options">
<div class="radio-button usa-radio" id="question_option_2695" data-id="2695">
<input type="radio" name="answer_20" id="answer_20_1" value="High school" class="usa-radio__input usa-radio__input--tile">
<label class="usa-radio__label" for="answer_20_1">High school</label>
</div>
<div class="radio-button usa-radio" id="question_option_2696" data-id="2696">
<input type="radio" name="answer_20" id="answer_20_2" value="Some college" class="usa-radio__input usa-radio__input--tile">
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Survey insights will be used to inform improvements to the AMS website. Participation is voluntary and all responses are confidential. This survey will take around 3 minutes to complete. SUCCESS alert message ERROR alert message I am satisfied with the service I received from this website.* I am satisfied with the service I received from this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* Strongly Disagree Disagree Neutral Agree Strongly Agree I was able to find the information I needed on this website.* I was able to find the information I needed on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree The information on this website was easy to understand.* The information on this website was easy to understand.* Strongly Disagree Disagree Neutral Agree Strongly Agree It took a reasonable amount of time to complete what I needed to do on this website.* It took a reasonable amount of time to complete what I needed to do on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree I understand the purpose of the information presented to me on this website.* I understand the purpose of the information presented to me on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree Are there any other comments or feedback you'd like to leave about your web experience today? 2500 characters allowed Are you a USDA Employee? 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USDA AGRICULTURAL MARKETING SERVICE - CUSTOMER EXPERIENCE SURVEY × The purpose of this survey is to gain insight into how to enhance USDA-AMS's online presence and service to our Nation. Survey insights will be used to inform improvements to the AMS website. Participation is voluntary and all responses are confidential. This survey will take around 3 minutes to complete. SUCCESS alert message ERROR alert message I am satisfied with the service I received from this website.* I am satisfied with the service I received from this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* Today's web experience increased my trust in the Agricultural Marketing Service (AMS).* Strongly Disagree Disagree Neutral Agree Strongly Agree I was able to find the information I needed on this website.* I was able to find the information I needed on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree The information on this website was easy to understand.* The information on this website was easy to understand.* Strongly Disagree Disagree Neutral Agree Strongly Agree It took a reasonable amount of time to complete what I needed to do on this website.* It took a reasonable amount of time to complete what I needed to do on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree I understand the purpose of the information presented to me on this website.* I understand the purpose of the information presented to me on this website.* Strongly Disagree Disagree Neutral Agree Strongly Agree Are there any other comments or feedback you'd like to leave about your web experience today? 2500 characters allowed Are you a USDA Employee? Are you a USDA Employee? Yes No Did any of the following impact your ability to use the website today? (Choose all that apply) Did any of the following impact your ability to use the website today? (Choose all that apply) Visual difficulty Hearing difficulty Motor difficulty Sensory difficulty Cognitive difficulty A disability or difficulty not listed above Prefer not to answer None of the above Which of the following do you identify with? (Choose all that apply) Which of the following do you identify with? (Choose all that apply) Parent Academic US Public Foreign Public USDA Facility Owner Community Leader Farmer Rancher US Government Official Foreign Government Official USDA Affiliate Scientist User of National Forests and Grasslands (hiking, fishing, etc.) Where are you located? (Zip Code) What is your highest level of education? What is your highest level of education? High school Some college College degree Graduate degree (Master's) Advanced degree (PhD, JD, MD, etc.) Prefer not to respond Option not listed Submit -------------------------------------------------------------------------------- According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0503-0024. The time required to complete this information collection is estimated to average 3 minutes per response, including the time for reviewing instructions and completing the collection of information. An official form of the United States government. Powered by Touchpoints OMB Approval #0503-0024 · Expiration Date 04/30/2023 Feedback