Sample Survey #2
(Do not fill this out!)
Survey Topic: Personal Shopping
Number of Questions: 20 - Payment for Completing Survey: $20.00
1. Please supply us with your contact information:
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Name: |
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Address: |
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City and State: |
Post Code: |
E-mail: |
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| 2. Do you currently use any "PRODUCT"? Yes No Don't know |
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| 3. What brand of "PRODUCT" are you currently
using? Brand 1 Brand 2 Brand 3 Brand 4 Brand 5 Other |
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| 4. How did you purchase this "PRODUCT"? Retail Store Direct Mail Catalog Web Company Other |
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| 5. Are there features that this product does not have that
you would want out of a "PRODUCT"? Yes No Don't know |
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| 6. What features does your "PRODUCT" not have
that you wish it did? |
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| 7. How much did you pay for your "PRODUCT"? |
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| 8. How satisfied are you with your "PRODUCT"? Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied |
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| 9. Of the following list of features, please select the
top three that would be of interest to you: Feature 1 Feature 2 Feature 3 Feature 4 Feature 5 Feature 6 |
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| 10. Of the three features you just listed, please rank
them first, second and third in importance to you: 1. 2. 3. |
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| 11. Are there any additional features that would be of
importance to you? Additional Feature 1 Additional Feature 2 Additional Feature 3 Additional Feature 4 Additional Feature 5 |
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| 12. Are there particular features that a product must have
for you to purchase it? Please list what they are in order of importance: Essential Feature 1 Essential Feature 2 Essential Feature 3 Essential Feature 4 Essential Feature 5 |
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| 13. How much would you be willing to pay for a product
with these features ("LIST FEATURES")? |
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| 14. If the "PRODUCT" was priced at (price) how
likely, on a percentage basis, would you be to buy it? (0% = Not at all likely to buy, 100% = Completely likely to buy) |
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| 15. How much are you authorized to spend on new products? |
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| 16. What do you think about the price of this
"PRODUCT"? Extremely Low Somewhat Low Just right Somewhat High Extremely High |
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| 17. Through what means would you be least likely to
purchase this "PRODUCT"? Retail Direct Mail Mail Order Catalog Classified Advertisement Telemarketer |
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| 18. Through what means would you be least likely to
purchase this "PRODUCT"? Retail Direct Mail Mail Order Catalog Classified Advertisement Telemarketer |
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| 19. What do you think would be a good name for such a
"PRODUCT"? |
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| 20. Can you please tell us which one of the following
possible product names you like the most? Product 1 Product 2 Product 3 Product 4 Product 5 |
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Thank
you for taking the time to participate in our survey about
personal shopping.
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