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Appendex F 
Facsimile of Research Questionnaire Form 
1 1 
1 
INSTRUCTIONS FOR PART 1: Complete the column on the left 
first, and then do the column on the right. Do not jump 
back and forth between lists. Just list examples however 
they come to mind. It is most important that you do these 
listings in one sitting, without help or discussion. 
Complete both listings before going on to the rest of the 
Juestionnaire, 
LIST 10 EXAMPLES OF 
THINGS YOU OWN. 
O-1 = 
0-2: 
0-3: 
0-4: 
0-5: 
0-6: 
0-7: 
0-8: 
O-9: 
0-10: 
LIST 10 EXAMPLES OF 
THINGS YOU DO NOT OWN. 
N-1: 
N-2: 
N—3: 
N—-4: 
N—5¢: 
N-6: 
N-=7-: 
N-8: 
N-9: 
N-10"-