|   |  
| Do you make purchases on the Internet?  |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| Would you purchase any of the following products on the Internet?  |  
  |   |  
 |  
  |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
| Please indicate whether you agree or disagree with the statements below.
 |  
  |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| Have you ever made a purchase from an Internet retailer?   |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
 |  With your last purchase from an Internet retailer, What did you buy?   |   |   |  
  |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| How much did you spend on this transaction? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
Was this purchase for yourself or for someone else?
  |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| When you began shopping on this occasion, were you: |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
| Thinking back to Internet retailers you've purchased from, have you ever: 
 |  
  |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| Do you shop at ROSS Dress for Less?   |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| In the past 3 months, How often do you shop at ROSS Dress for Less? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| Which Departments did your last purchase come from? (You may check more than one) |  
  |   |  
 |  
  |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| How much did you spend on your last purchase? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| Please indicate how likely you are to make a purchase, If ROSS Dress for Less made Internet shopping available. |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
| If ROSS Dress for Less sold the following list of products on the Internet, How likely are you to purchase these products on the Internet?
 |  
  |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            | 
                
                
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
 |  What is your age? (Please specify in Years)   |   |   |  
  |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| Please indicate your current marital status. |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| Please indicate the number of children under 18 years of age currently living in your household? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
|   |  
| Into which of the following categories does your total (approximate) personal income before taxes, fall? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 | 
            
        
        
    
        
            
                
                
                       
 |  
| Who is entering the survey information? |  
  |   |  
 |   
                 
                
             | 
        
        
        
        
        
        
            
                | 
                       
                 |