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Survey Name Demographic questionnaire
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What is your age?
 
   
 
What is your gender?
 
   
 
What is your primary language?

 
   
 
What is the highest level of education you have completed?
 
   
 
How would you classify yourself?
 
   
 
What is your current marital status?
 
   
 
Where do you currently reside?
 
   

How long have you been living there?
 
   

Where were you born?
 
   
 
What is your current household income in U.S. dollars?
 
   
 
Which of the following best describes the area you live in?
 
   
 
How many children under 16 years old live in your household?
 
   
 
Which of the following categories best describes your primarily area of employment (regardless of your actual position)?
 
   
 
Which of the following best describes your role in industry?
 
   
 
The organization you work for is in which of the following:
 
   
 
What is your organization's total budget for this year, from all sources?
 
   
 
How long have you been using the Internet?
 
   

How frequently do you access the web from the following places?
Daily Weekly Monthly Less than once a month Never
From home (including a home office)
From work
From school
From a public terminal (e.g. library, cybercafe, etc.)
From other places
 
   
 
Who pays for your Internet access? (Please check all that apply.)
 
   
 
What is your primary computing platform?
 


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