Biometric Modality: _________________ Date: ___________
Demographic Questionnaire
1. Age: ____________
2. Gender: (circle one) male female
3. Handedness: (circle one) right handed left handed Ambidextrous
4. Height: ______________ feet ____________ inches
5. Ethnicity: _______________________________________
6. Profession: ______________________________________________
7. Have you ever had your biometrics captured before? (circle one) yes no
If yes check all that apply:
___ Fingerprinted with ink/paper
___ Fingerprinted electronically
___ Palm Print
___ Eye Scan
___ Face Image
___ Voice
___ Hand geometry
8. How concerned are you about having your biometrics recorded?
| 1 | 2 | 3 | 4 | 5 | 
| Very concerned | Fairly Concerned | Not very concerned | Not all concerned | Don’t know | 
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| File Title | PAPERWORK REDUCTION ACT | 
| Author | pboyd | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-30 |