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Hello:
You are invited to participate in our survey for Everlasting Gum. In this survey, approximately twenty people will be asked to complete a survey that asks questions about their opinions on chewing gum. 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 John Doe at 604-555-0129.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
Do you chew gum?
 
Yes
 
No
 
 
 
How often do you chew gum?
 
Daily
 
Weekly
 
Monthly
 
Never
 
 
 
Why do you chew gum (Select all that apply)?
 
Fresh breath
 
Snacking
 
After smoking/drinking
 
Other

 
 
 
What do you consider when purchasing gum (Select all that apply)?
 
Flavor
 
Brand
 
Price
 
Other

 
 
 
Do you buy multi-pack chewing gum?
 
Yes
 
No
 
Sometimes
 
 
 
Does advertising influence your decision on buying chewing gum?
 
Yes
 
No
 
 
 
Where do you purchase your chewing gum (Select all that apply)?
 
Local Supermarket
 
Gas Station
 
Convenience Store
 
Vending Machine
 
Other

 
 
 
Do you prefer sugar-free gum?
 
Yes
 
No
 
 
 
Are you male or female?
 
Male
 
Female