Click to create your own form using this template   
More
Templates

          
LOADING...  Please wait.

Public Opinion Survey
Personal Information
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

How many children live in your household?*
None
1
2
3
4 or more

Are you currently registered to vote?*
Yes
No

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

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

Q & A
TABOR: (Various Taxpayers` Bill of Rights [TABOR] proposals would provide such features as limitation against higher taxation, limitation of government spending, or requirement of voter approval for some types of taxation.)
Do you favor a more restrained growth of government growth and spending through some form of TABOR?*
Yes
No
No Opinion

Senior Citizen Homestead Act: (This act would authorize limited tax relief for certain senior citizen homeowners by freezing residential property tax assessments.)
Do you favor this tax relief for senior citizens?*
Yes
No
No Opinion

Sales tax abolishment:
Should the sales tax on grocery food purchases be abolished?*
Yes
No
No Opinion

Tax swap: (Favor paying higher taxes on tobacco products and/or alcoholic beverages, if the sales tax on grocery items is reduced or abolished.)
Would you favor this tax legislation?*
Yes
No
No Opinion

Your taxes: (Amount of all taxes (federal, state, and local) that you pay or have withheld from your income.)
How do you feel about these taxes?*
Too Much
About Right
Too Little
No Opinion

School bus safety:
Should local school boards be required to install seat belts on public school buses?*
Yes
No
No Opinion

Public education:
Which is the better use of education funds?*
Expand Pre-K Education
Improve Existing K-12 Education
Improve High Education (Universities & Colleges)
No Opinion

Voter photographic identification:
Should photographic identification be required before a person may vote?*
Yes
No
No Opinion

English-only driver`s license testing:
Should testing for a driver`s license be conducted only in English?*
Yes
No
No Opinion

Illegal immigration:
Should it be illegal for an employer to employ an illegal immigrant?*
Yes
No
No Opinion

Eminent domain: (In 2005, the U.S. Supreme Court ruled [Kelo vs City of New London] that a government may use eminent domain to condemn privately owned property and sell it to a developer, if the developer can provide more income for the government [jobs, taxes].)
Should we prevent government from condemning private property to sell to a developer?*
Yes
No
No Opinion

Alternative energy: ( State tax revenues be used to encourage development and use of alternative fuels (bio-fuels, wind, solar).)
Do you favor state revenues to be used for alternative energy?*
Yes
No
No Opinion

Reset 
Powered by Elbowspace.com