0%
Exit Survey »
 
 
1. Hello:
You are invited to participate in our survey 001. In this survey, approximately ONE HUNDRED people will be asked to complete a general market questionnaire. It will take approximately FIVE minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Sonia Toledo by email at [email protected].

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
2. Are you:
 
Male
 
Feamle
 
 
 
3. What is your age?
 
15-19
 
20-29
 
30-39
 
40-49
 
50-59
 
60 or over
 
 
 
4. What is the highest level of education you have completed to date? (please check only one.)
 
Attended High School
 
Graduated High School
 
Attended College
 
Graduated College
 
Post-Graduate Study w/o Degree
 
Post-Graduate Degree
 
 
 
5. What is your Marital Status?
 
Single, Never Married
 
Married
 
Separated or Divorced
 
Widowed
 
 
 
6. In which state and ZIP code area is your main residence?
   
 
 
 
7. Please indicate total annual PERSONAL income. (Include income from all sources).
 
Less than $30,000
 
$30,000-$39,000
 
$40,000-$49,000
 
$50,000-$59,000
 
$60,000-$74,999
 
$75,000-$99,999
 
$100,000-$149,000
 
$150,000-$249,999
 
$250,000-$499,999
 
$500,000-$999,999
 
$1,000,000 or more
 
 
 
8. Do you own a home, condominium or co-op as your primary residence?
 
Yes
 
No
 
 
 
9. In what type of business, industry or profession are you primarily engaged?
 
Agriculture/forestry/construction
 
Transportation/public utilities
 
Data processing/computers
 
Finance/banking/insurance
 
Education
 
Manufacturing
 
Health care (medical, dental, etc,)
 
Government/ public administration
 
Communications/ Publishing
 
Real estate
 
Wholesale trade
 
Retail Trade
 
Personal/business services
 
Unemployed
 
Other
 
 
 
 
10. What is your title, position, or rank?
   
 
Powered by