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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
What is your age?
 
0-15 years
 
16-30 years
 
31-40 years
 
 
 
What is your sex?
 
Male
 
Female
 
 
 
what is your ethnicity?
 
Black or African American
 
American Indian or Alaska Native
 
Asian or Asian American
 
Hispanic or Latino
 
Non-Hispanic White
 
 
 
Are you
 
Married
 
Single
 
Divorced
 
Seperated
 
Widowed
 
 
 
What is your religion?
 
Christianity
 
Islam
 
Others
 
 
 
Do you believe religion could cause crisis?
 
Yes
 
No
 
Neural
 
 
 
Have you heard about a terorrist attacks?
 
Yes
 
No
 
 
 
Do you believe religous leaders can stop terorrist attack?
 
Yes
 
No
 
Neutral
 
 
 
Have you experience crisis or disaster before?
 
Yes
 
No