Name

Surname

Sex
Select your sex Female Male Other

Date of birth*

Place of birth

Place of residence

Nationality*

 

Please indicate your level of education*

If you attended any other courses with a final examination and/or with a teacher (minimum 6 months), indicate below their total duration (count 0.5 each 6 months)

Please state what paid work you have done in your adult life and for how many years (counting from 18 onward). If you have done more than one job, you can add them using the "Add Job" button, up to a maximum of 5. If you have never worked, select the box at the bottom.*

Instructions: Begin by writing the name of your profession and choose from those suggested. If your job does not appear, select the closest one.

Work	Years

If you have never worked, check this box.

 

Have you ever read newspapers or magazines (no social network) at least three times a week? *

No
Yes

Have you ever spent your free time in leisures activities (for example sports, artistic activities, board games, crafts, gardening, puzzles, embroidery, photography, etc.) at least three times a week? *

No
Yes

Have you ever attended conferences, concerts or exhibitions at least three times a year? *

No
Yes

Have you ever taken trips or holidays lasting more than one day at least three times a year? *

No
Yes

Have you ever read at least three books per year? *

No
Yes

Do you have children?*

No
Yes

Did you fill out the questionnaire by yourself?*

Date of compilation*

Would you like to allow anonymous use of the information entered to improve the quality of the tool?*

Yes
No