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Surveys
2011
October
M
M11-001Pre-Qual
M11-001Pre-Qual
Thank you for taking the time to pre-qualify for our upcoming survey at Bryles Research. Please answer all of the questions within the survey that follows. This should take you approximately 3-5 minutes.
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1. We are conducting a survey among mothers with babies. Do you have a baby aged between 6-48 months wearing diapers?
Yes
No
*
2. Sometimes the type of work people do affects the products they buy. Are you, or is any member of your household employed in any of the following occupations?
An advertising agency or market research firm
As a financial consultant, bank manager or employed by investment or brokerage firms
As a manager of a grocery store, supermarket, mini/quick market, discount store, drug store, or mass merchandiser
A news media such as radio, television, or newspaper
A company that processes or manufactures paper products
A company that processes or manufactures baby care products
None of the above
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4. Have you, yourself, participated in any market research survey(s) about Baby Care within the past 6 months, or not?
Yes
No
*
5. Are you a first time mom, or not?
YES
NO
7. Please select the weight range of each child aged 6-48 months. if you have less children than displayed, please select NA as an option for child 2 and/or 3.
0-8 pounds
9 - 14 pounds
15 - 20 pounds
21 - 27 pounds
28 - 34 pounds
35 - 40 pounds
41 - 50 pounds
over 50 pounds
N/A
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Child 1
*
Child 2
*
Child 3
*
9. Are you, yourself responsible for shopping for Baby Care products (e.g. diapers, etc.) in your household?
Yes
No
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11. In just the past 3 months, what types of diaper have been used for your child? That is, disposable only, cloth only or both cloth and disposable?
Disposable only
Cloth only
Cloth mostly
Disposable mostly
Both cloth and disposable equally
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12. What size diaper does your child currently wear
Size 1
Size 2
Size 3
Size 4
Size 5
Size 6
Larger / other
Thank you for taking the time to answer the questions for this potnetial proejct. Our staff will be reviewing your responses and will be contacting you if you may qualify to ask some additioanl information.
Please confirm your contact information so we can call you back at the correct phone number
*
First Name
:
*
Last Name
:
*
Phone XXX-XXX-XXXX
:
Did someone refer you to this survey? If so please enter their information below so they can get credit for the referral.
First Name
:
Last Name
:
Phone
:
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