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Basic Market Survey Questionnaire Example

The document is a basic market survey questionnaire that collects demographic information about respondents. It includes questions about gender, age, education level, marital status, number of children, personal and household income, home ownership status, property values, and total net worth. The questionnaire is used to gather market research data from participants on various personal and financial attributes.

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Jimbert Amantillo
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29 views3 pages

Basic Market Survey Questionnaire Example

The document is a basic market survey questionnaire that collects demographic information about respondents. It includes questions about gender, age, education level, marital status, number of children, personal and household income, home ownership status, property values, and total net worth. The questionnaire is used to gather market research data from participants on various personal and financial attributes.

Uploaded by

Jimbert Amantillo
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Example – Basic Market Survey Questionnaire

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1. Are you:
 Male  Female

2. What is your age?


 18-24  25-34
 35-44  45-54
 55-64  65 or over

3. What is the highest level of formal education you have completed? (Please check only one.)
 Attended High School  Graduated High School
 Attended College  Graduated College
 Post-Graduate Study Without Degree  Post-Graduate Degree

4. What is your marital status?


 Married  Single, Never Married
 Separated or Divorced  Widowed

5. How many children under the age of 18 live in your household? __________

6. What is your total annual personal income? (Include income from all sources— salary,
bonuses, investment income, rents, royalties, etc. Please check only one.)
 Less than $30,000  $30,000 - $39,999
 $40,000 - $49,999  $50,000 - $59,999
 $60,000 - $74,999  $75,000 - $99,999
 $100,000 - $149,999  $150,000 - $249,999
 $250,000 - $499,999  $500,000 - $999,999
 $1 million or more

7. In which state and ZIP code area is your main residence?

State: _____________ ZIP code: _____________

8. What is your total annual household income? (Include income for all family members and
include all sources—salary, bonuses, investment income, rents, royalties, etc. Please check only
one.)
 Less than $30,000  $30,000 - $39,999
 $40,000 - $49,999  $50,000 - $59,999
 $60,000 - $74,999  $75,000 - $99,999
 $100,000 - $149,999  $150,000 - $249,999
 $250,000 - $499,999  $500,000 - $999,999
 $1 million or more

9a. Do you own a home, condominium or co-op as your primary residence?


 Yes  No

9b. If “Yes,” what is the present market value of your primary residence?
 Under $100,000  $100,000 - $199,999
 $200,000 - $299,999  $300,000 - $499,999
 $500,000 - $749,999  $750,000 - $999,999
 $1 million - $1.9 million  $2 million or more
If $2 million or more, please estimate value: _______________________________ (please
specify)
10. Do you own a second home, condominium or co-op?
 Yes  No

11. What is the total net worth of yourself and all members of your household? Include the
estimated market value of your business if you own one, all real estate, including primary
residence, car, household possessions, bank accounts, stocks, bonds and other investments and
assets.
 Less than $50,000  $50,000-$99,999
 $100,000-$249,999  $250,000-$499,999
 $500,000-$749,999  $750,000-$999,999
 $1 million -$1.4 million  $1.5 million -$1.9 million
 $2 million -$4.9 million  $5 million -$9.9 million
 $10 million and over

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