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* Name:
   
* AGE :
   
* Mobile No :
   
* Email Id :
   
* City :
   
 
 
 
How old are you ?
 
17 or younger
 
18-20
 
21-29
 
31-39
 
41-49
 
51-59
 
 
 
Gender?
 
Male
 
Female
 
 
 
What is the highest level of your completed Education?
 
Less than high school
 
High school degree or equivalent (e.g., 10 / +2)
 
Some college but no degree (Diploma,ITI, Degree Not completed)
 
Bachelor degree
 
Post Graduate degree
 
Professional Bachelor degree
 
Professional Post Graduate degree
 
 
 
Which of the following categories best describes your employment status?
 
Employed, working 1-39 hours per week
 
Employed, working 40 or more hours per week
 
Not employed, looking for work
 
Not employed, NOT looking for work
 
HouseWife
 
Retired
 
Disabled, not able to work
 
 
 
What is the level of education of the Chief wage earner? Cheif Wage earner means who contributes more for the household expenses?
 
Less than high school
 
High school degree or equivalent (e.g., 10 / +2)
 
Some college but no degree (Diploma,ITI, Degree Not completed)
 
Bachelor degree
 
Post Graduate degree
 
Professional Bachelor degree
 
Professional Post Graduate degree
 
 
 
What Is the occupation of the chief wage Earner?Cheif Wage earner means who contributes more for the household expenses?
 
Unskilled Worker
 
Skilled worker
 
Petty trader
 
Shop Owner
 
Businessmen/Industrialist (No. of employees)- None
 
Businessmen/Industrialist (No. of employees)- 1-9
 
Businessmen/Industrialist (No. of employees)- 10+
 
Self employed professional
 
Clerical/Salesman
 
Supervisory level
 
Officers/Executives - Junior
 
Officers/Executives -Middle/Senior
 
 
 
What is your yearly household income? Household income means all ways which earn money to your family like salaries, rent, investment, intrest etc... its for research purpose purely confidential...
 
Less than Rs.2,00,000
 
Rs.2,00,000 to Rs.3,49,999
 
Rs.3,50,000 to Rs.4,99,999
 
Rs.5,00,000 to Rs.7,49,999
 
Rs.7,50,000 to Rs.9,99,999
 
Rs.10,00,000 to Rs.14,99,999
 
Rs.15,00,000 or more
 
 
 
Are You interested to participate in online survey? In which the link for survey will be sent to your mail id and you will be gifted on monthly basis...
 
YES
 
NO