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Exit Survey
 
 
Today we would like you to answer a few questions that will only take 10 minutes of your time. 
 
 
 
What is your gender?
 
male
 
female
 
 
 
What is your age?
 
18-24
 
25-34
 
35-44 
 
45-54
 
55-64
 
65-74 
 
75 or older
 
 
 
What region do you live in?
 
New England (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut)
 
New England (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut)
 
East North Central (Ohio, Indiana, Illinois, Michigan, Wisconsin)
 
East North Central (Ohio, Indiana, Illinois, Michigan, Wisconsin)
 
South Atlantic (Delaware, Maryland, District of Columbia, Virginia, West Virginia, North Carolina, South Carolina, Georgia, Florida)
 
  East South Central (Kentucky, Tennessee, Alabama, Mississippi)
 
West South Central (Arkansas, Louisiana, Oklahoma, Texas)
 
  Mountain (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada)
 
Pacific (Washington, Oregon, California, Alaska, Hawaii)
 
 
 
What is your race/ethnicity
 
White/Caucasian
 
Black/African American
 
Hispanic/Non-White
 
Asian/Pacific Islander
 
Native American/Aleutian Eskimo
 
Multi -race
 
Other
 
Prefer not to answer
 
 
 

What is your employment situation?
 
I work full time
 
I work part time
 
I am not employed
 
 
 

How long have you been employed for?
 
1-3 years
 
4-6 years
 
7-9 years
 
10 years or longer
 
 
 
Does your company give recognition awards?
 
yes and I have received one
 
yes but I have never received one
 
no
 
I don't know
 
 
 

What item do you want to see more of/what item do you like most
 
ring
 
necklace
 
bracelet
 
other
 
 
 

what color do you want this item to be
 
red
 
orange
 
yellow
 
green
 
blue
 
purple
 
pink
 
black
 
silver
 
gold
 
other