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  1. Surveys
  2. 2012
  3. July
  4. P
  5. Polythecnic Ass 1
0%
Exit Survey »
 
 
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.

 
 
 
Below is a list of statements. Please indicate how you feel about each statement by indicating your degree of agreement or disagreement with each statement.
Strongly agree Agree Neutral Disagree Strongly disagree Not sure
Financial security is very important to me.
I'd say I'm rebelling against the way I was brought up.
I believe that "industrial growth" should be limited.
Generally speaking, most people are trustworthy and honest.
Everything is changing too fast today.
In general, it's more important to understand my inner self than to be famous, powerful, or wealthy.
My greatest achievements are ahead of me.
I believe a woman can work outside the home even if she has small children and still be a good mother.
I certainly am more conventional than experimental.
I like to try new and different things.
Strongly agree Agree Neutral Disagree Strongly disagree Not sure
It's very important to me to feel I am a part of a group.
Overall, I'd say I'm very happy.
TV is my main form of entertainment.
I'm a "spender" rather than a "saver."
I would rather spend a quiet evening at home than go out to a party.
My family is the single most important thing to me.
I think I have more self-confidence than most people.
I like to think I'm a bit of a swinger.
A woman's life is fulfilled only if she can provide a happy home for her family.
My social status is an important part of my life.
I act on my hunches.
 
 

Is your home
 
a single family house
 
a two family house
 
an apartment
 
a mobile home
 
Other
 
 
 
 
Are you (Check all that apply)
 
married
 
divorced
 
widowed
 
separated
 
single
 
step parent

 
 
 
Indicate total household income:
 
under $25,000
 
$25,000 - $29,999
 
$30,000 - $34,999
 
$35,000 - $39,999
 
$40,000 - $49,999
 
$50,000 - $59,999
 
$60,000 - $84,999
 
Over $85,000
 
 
 
Indicate activities/interests which you and/or household members enjoy on a regular basis:
 
Bicycling/running
 
Camping
 
Dieting
 
Crafts
 
Foreign travel
 
Gourmet/fine food
 
Coin/stamp collecting
 
Fashion clothing
 
Bible/devotional reading
 
Physical fitness/exercise
 
Stereo/records and tapes
 
Sweepstakes
 
Sewing
 
Needlework/knitting
 
Art/antiques
 
Outdoor gardening
 
Wildlife/environment issues
 
Do-it-Yourself/workshop
 
Recreational vehicles
 
Health foods/vitamins
 
Money making opportunities
 
Video cassette recordings
 
Book reading
 
Self improvement
 
Compact discs
 
Watching sports on TV
 
Charities/volunteer work
 
Other
 
 
Thinking back to your experience with , please indicate your degree of agreement with the following statements.
INTERNET RETAILER
Strongly agree Agree Neutral Somewhat disagree Disagree Strongly disagree Not sure
I prefer making a purchase from to using local offices, malls or stores. INTERNET RETAILER
I prefer over other home shopping services (i.e., catalogs, "1-800" services or television). INTERNET RETAILER
doesn't just sell products or services--it entertains me. INTERNET RETAILER
I received special rewards and discounts from doing business with . INTERNET RETAILER
I say positive things about to other people. INTERNET RETAILER
I consider to be my first choice when I need products or services of this type. INTERNET RETAILER
The "look" of web site is appealing to me. INTERNET RETAILER
I really like doing business with INTERNET RETAILER
I intend to continue to visit site in the future. INTERNET RETAILER
I intend to purchase from in the future. INTERNET RETAILER
is one of the first places I intend to look when I need the type of merchandise or services it provides. INTERNET RETAILER
It would require a lot of time and effort on my part, to set up an account with another . INTERNET RETAILER
It would take a lot of time and energy to look for another for this type of product. INTERNET RETAILER
The products and/or services I purchased from were a good value. INTERNET RETAILER
 
 
Below is a list of statements. Please indicate how you feel about each statement by indicating your degree of agreement or disagreement with each statement.
Strongly agree Agree Neutral Disagree Strongly disagree Not sure
Financial security is very important to me.
I'd say I'm rebelling against the way I was brought up.
I believe that "industrial growth" should be limited.
Generally speaking, most people are trustworthy and honest.
Everything is changing too fast today.
In general, it's more important to understand my inner self than to be famous, powerful, or wealthy.
My greatest achievements are ahead of me.
I believe a woman can work outside the home even if she has small children and still be a good mother.
I certainly am more conventional than experimental.
I like to try new and different things.
Strongly agree Agree Neutral Disagree Strongly disagree Not sure
It's very important to me to feel I am a part of a group.
Overall, I'd say I'm very happy.
TV is my main form of entertainment.
I'm a "spender" rather than a "saver."
I would rather spend a quiet evening at home than go out to a party.
My family is the single most important thing to me.
I think I have more self-confidence than most people.
I like to think I'm a bit of a swinger.
A woman's life is fulfilled only if she can provide a happy home for her family.
My social status is an important part of my life.
I act on my hunches.
 
 
Please check the frequency in which you engaged in the following activities in the past two months. Check only one answer for each possible leisure activity.
Frequently Occasionally Seldom Never Not sure
Watching television
Playing adult games (for example, cards, mahhjong, etc.)
Walking for pleasure
Reading books for pleasure
Competing in team sports (for example, soccer, baseball, basketball, etc.)
Going on a family outing
Competing in individual sports (for example, tennis, ping pong, etc.)
Going out for the evening for drinks and entertainment
Bicycling
Going to the movies
Frequently Occasionally Seldom Never Not sure
Visiting art galleries and museums
Listening to music
Collecting or making something (for example, hobbies)
Swimming
Attending sports events
Attending opera, ballet or dance performances
Surfing the Web
Working on the computer
 
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