Survey Topic: "Sample"
Number of Questions: 20
Payment for Completing Survey: $40 USD
1.
Please supply us with your contact
information:
Name:
Organisation:
Address:
City
and State:
ZIP Code:
E-mail:
2.
Do you currently use any "PRODUCT"?
Yes
No
Don't know
3.
What brand of "PRODUCT" are you currently
using?
Brand 1
Brand 2
Brand 3
Brand 4
Brand 5
Other
4.
How did you purchase this "PRODUCT"?
Retail Store
Direct Mail
Catalog
Web
Company
Other
5.
Are there features that this product
does not have that you would want out
of a "PRODUCT"?
Yes
No
Don't know
6.
What features does your "PRODUCT"
not have that you wish it did?
7.
How much did you pay for your "PRODUCT"?
8.
How satisfied are you with your "PRODUCT"?
Very Satisfied
Somewhat Satisfied
Somewhat Dissatisfied
Very Dissatisfied
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
10.
Of the three features you just listed,
please rank them first, second and third
in importance to you:
1.
2.
3.
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
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
13.
How much would you be willing to
pay for a product with these features
("LIST FEATURES")?
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)
15.
How much are you willing to spend
on new products?
16.
What do you think about the price
of this "PRODUCT"?
Extremely Low
Somewhat Low
Just right
Somewhat High
Extremely High
17.
Through what means would you be most
likely to purchase this "PRODUCT"?
Retail
Direct Mail
Mail Order Catalog
Classified Advertisement
Telemarketer
18.
Through what means would you be least
likely to purchase this "PRODUCT"?
Retail
Direct Mail
Mail Order Catalog
Classified Advertisement
Telemarketer
19.
What do you think would be a good
name for such a "PRODUCT"?
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
Thank
you for taking the time to complete
this survey. Click on "Submit" to send
your responses to us.
