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Hi:

I am with [MARKET_RESEARCH_COMPANY], a market research company based in [LOCATION]. We are conducting a survey about [SUBJECT] that might be of interest to you. We would like to include your opinions in this study. This is a marketing research study only, and we will not attempt to sell you anything at all today or in the future.




Thank you for your participation
 
 

Branching: Pick only age group 25-64


Age
Which of the following best describes your age?
 
 

Branching: Discard Retired..


Employment
Do you work full time or part time, outside the home?
 
Full-time [35+ Hours per week]
 
Part-time [15-20 Hours per week]
 
Full-time homemaker
 
Retired
 
 

Branching: High School Graduates and Above


Education
Which of the following best describes the highest level of education completed?
 
Some High School
 
High School Graduate
 
Some College
 
Graduated College
 
Post Graduate
 
 

Family Status
Which of the following statements applies to you:
 
I have children under the age of 6 living at home
 
I have children between the ages of 6 and 17 living at home
 
I have no children under the age of 18 living at home
 
 

Online Services
a. Do you log on and use the Internet by yourself, without help, at either work or home?
 
Yes
 
No
 

b. How long have you been using the Internet, by yourself?
 
Less than 6 months
 
6 – 12 months
 
1 - 2 year
 
More than 2 years
 

c. How often do you use the Internet, not including email, by yourself, either at work or at home?
 
Less than one hour/week
 
1 – 2 hours/week
 
2 – 3 hours/week
 
More than 3 hours/week
 

d. On a scale of 1 to 5, with 1 being the least comfortable and 5 being the most comfortable, how comfortable and familiar are you using the Internet, including such things as links, site addresses, or search engines?
Least (1)
2 3 4 Most (5)
 
 

Computer Usage
When using the Internet, either at home or at work, which do you use more often?
 
IBM Compatible PC
 
Mac
 
 

Branching: End if involved in prior market research studies


Research Experience
Aside from political surveys, have you participated in any market research studies such as panel discussions, focus groups or surveys, in the last 12 months?
 
Yes
 
No
 
 
 
* Name
   
Phone
   
* Email Address
   
 
 


Thank You for completing the Questionnaire... Your honest responses are truly appreciated.


Please click on the Finish Survey button to complete this Survey.
 
 
 
Indicate your marital status.
 
Single
 
Married
 
Widowed
 
Divorced
 
 
 
Please indicate your approximate yearly household income before taxes. (Include total income of all adults living in your household.)
 
Under $25,000
 
$25,001 - $49,999
 
$50,000 - $74,999
 
$75,000 - $99,999
 
$100,000 -$149,999
 
$150,000 and over
 
 
 
What was the last grade you completed in school?
 
Some high school
 
High school graduate
 
Some college
 
College graduate
 
Postgraduate/professional
 
 
 
What is your current work status?
 
Work outside home full time
 
Work outside home part time
 
Do not work outside home
 
 

Computer Usage
When using the Internet, either at home or at work, which do you use more often?
 
IBM Compatible PC
 
Mac
 
 
 
What was the last grade you completed in school?
 
Some high school
 
High school graduate
 
Some college
 
College graduate
 
Postgraduate/professional
 
Please contact [email protected] if you have any questions regarding this survey.
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