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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] 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 [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

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

 
 
 
 
How do you feel about on-line shopping in supermarkets?
 
I like it
 
Don't like it
 
Never did it
 
 
 
Do you purchase mainly in the physical retail store or on-line?
 
Physical retail store
 
Online store
 
Purchase from both equally
 
 
 
Which range includes your age
 
Younger than 18
 
18-24
 
25-34
 
35-44
 
45-54
 
55-64
 
65 or older
 
Prefer not to answer
 
 
 
Which supermarket do you shop at ?
 
Trimart
 
Big B
 
Super Centre
 
Carlton A1
 
Popular Discount
 
Emerald City
 
Other
 
 
 
How often do you shop in-store ?
 
Daily
 
Weekly
 
Once every two weeks
 
Once every Month
 
More than 3 times a month
 
 
 
Please indicate your gender
 
Male
 
Female
 
Prefer not to answer
 
 
 
How likely are you to do business with us ?
 
Very likely
 
Somewhat likely
 
Neutral
 
Somewhat unlikely
 
Very unlikely
 
 
 
How interested are you in this service?
 
Very Interested
 
Somewhat Interested
 
Neutral
 
Somewhat Uninterested
 
Very Uninterested
 
 
 
Which of the following factors would increase your likelihood of using our service ?
 
Better service quality
 
More benefits
 
Better customer service
 
Flexibility in time commitment
 
Convience