Internet User Survey

Internet User Survey
Survey Security
*Password:       
Personal Information
*How did you here about us?       
Television
Radio
Newspaper
Friend
Search Engine
User Group
Direct Mail
Telemarketing
Other
*What is your gender?        
Male
Female
*How would you classify yourself?       
Rather not say
Caucasian/White
African American
Indigenous or Aboriginal
Asian/Pacific Islander
Hispanic
Latino
Multiracial
Other
*What is your marital status?       
Rather not say
Single
Married
Divorced
Widowed
*What is your age?       
Rather not say
Under 13
13 - 15
16 - 20
21 - 25
26 - 29
30 - 39
40 - 49
50 - 59
60 - 69
70 or above
*What is your annual household income?       
Rather not say
Under $10,000
$10,000 - $19,999
$20,000 - $29,999
$30,000 - $39,999
$40,000 - $49,999
$50,000 - $59,999
$60,000 _ $69,999
$70,000 - $79,999
$80,000 - $89,999
$90,000 - $99,999
$100,000 or above
*Where are you located?       
U.S. North East
U.S. South East
U.S. Mid West
U.S. Great Plains
U.S. North West
U.S. South East
Canada
*Describe the area you live in.       
Urban
Suburban
Rural
*What is highest level of education completed?       
Grammar School
High School or equivalent
Vocational/Technical School
Some College
Associates Degree (2 year)
College Graduate (4 year)
Master`s Degree (MS)
Doctoral Degree (PhD)
Professional Degree (MD etc.)
Other
*Are you currently registered to vote?       
Yes
No
*How many children live in your household?       
None
1
2
3
4 or more
Employment or Business Information
*What type of industry do you work in?       
*What type of role do you perform?       
Upper Management
Middle Management
Junior Management
Administrative Staff
Support Staff
Student
Trained Professional
Skilled Laborer
Consultant
Temporary Employee
Researcher
Self-employed/Partner
Other
*The organization you work for is in which of the following:       
Public sector (government)
Private sector (businesses)
Not-for-profit sector
Don`t know
Other
*The main source of revenue for your organization is:       
Sales to individuals
Sales to private businesses
Sales to government
Contracts to individuals
Private business contracts
Government contracts
Other organization contracts
Government appropriations
User charges and fees
Donations
Other
Don`t know
Internet Usage Information
*Which of these groups have you become more connected to through the Internet?       
None
Common political groups
Common hobbies/recreational
People who share my religion
People in my profession
People in my family
Common life situations
Other groups
*How often do you give false information on the internet?       
Never falsified information
Under 25% of the time
26 - 50% of the time
51 - 75% of the time
Over 75% of the time
Never registered with a site
*How long have you been using the Internet?       
Less than 6 months
6 to 12 months
1 to 3 years
4 to 6 years
7 years or more
*Home web access: How often?       
Daily
Weekly
Monthly
Less than once a month
Never
*Work web access: How often?       
Daily
Weekly
Monthly
Less than once a month
Never
*School web access: How often?       
Daily
Weekly
Monthly
Less than once a month
Never
*Public web access: How often?       
Daily
Weekly
Monthly
Less than once a month
Never
*Who pays for your Internet access?       
Self/Spouse
Parents
Work
School
Other
Don`t Know
*How often do you make purchases online?       
Daily
Weekly
Monthly
Less than once a month
Never
*Reason for not shopping online:       
Never tried it
Too complicated to place order
Faster to purchase locally
Not familiar with vendor
Credit card security
No receipt/documentation
Unknown quality
Not enough information
Uncomfortable with the idea
Other people`s bad experiences
My bad experience in the past
Personal information privacy
Don`t have a credit card
Against company procedures
Prefer to deal with people
Hard to find specific web site
No option to purchase
No one to receive the delivery
Other reasons
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