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Chase's Internet Usage Survey

What is your primary computing platform?

How long have you been using the Internet (including using e-mail, gopher, ftp, etc.)?

How frequently do you access the web from the following places?

	Daily	Weekly	Monthly	Less than once a month	Never
From home (including a home office)

From work

From school

From a public terminal (e.g. library, cybercafe, etc.)

From other places

Who pays for your Internet access?

During an average week, most of your professional correspondence (postal mail or e-mail) is with which of the following:

Public sector (e.g. government)

Private sector (e.g. most businesses and individuals)

Not-for-profit sector

Do not know

Other

Personal Information

Date of Birth

What is your sex?

Female

Male

What is your current marital status?

Ethnicity

Note: This is a sensitive question that can help Internet developers to understand the needs of current Web users--it is not intended to offend.

Please indicate your current household income in U.S. dollars

How many children under 16 years old live in your household?

Are you disabled or impaired?

Note: This is a sensitive question that can help Internet developers to understand the needs of current Web users--it is not intended to offend.

Location

Where are you located?

What is your primary language (i.e., the one you speak most of the time)?

Professional Information

Are you currently registered to vote?

Yes

No

N/A

Please indicate the highest level of education completed.

Grammar School

High School or equivalent

Vocational/Technical School (2 year)

Some College

College Graduate (4 year)

Master's Degree (MS)

Doctoral Degree (PhD)

Professional Degree (MD, JD, etc.)

Other

Which of the following categories best describes the industry you primarily work in ?

Which of the following best describes your role in industry?

Please indicate which of the following are sources of revenue for your organization:

Chase's Internet Usage Survey