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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 gender?
 
Male
 
Female
 
 
What is your marital status?
 
Single (Never married)
 
Married
 
Domestic partnership
 
Widowed
 
Divorced
 
Separated
 
Don’t know
 
 
What is your age?
 
Younger than 18
 
18 - 24
 
25 - 34
 
35 - 44
 
45 - 54
 
55 - 64
 
65 or older
 
Prefer not to answer
 
 
What is the highest level of education you have achieved?
 
Less than high school degree
 
High school degree or equivalent (e.g. GED)
 
Some college but no degree
 
Associate degree (e.g. AA, AS)
 
Bachelor's degree (e.g. BA, AB, BS)
 
Master's degree (e.g. MA, MS, MBA)
 
Professional degree (e.g. MD, DDS, JD)
 
Doctorate degree (e.g. PhD)
 
 
Which category best describes your annual income?
 
Under $15,000
 
$15,000 - $29,999
 
$30,000 - $44,999
 
$45,000 - $59,999
 
$60,000 - $74,999
 
$75,000 - $89,999
 
$90,000 - $104,999
 
$105,000 - $119,999
 
$120,000 or more
 
Prefer not to answer
 
 
What is your religious preference?
 
Mormon
 
Jewish
 
Roman Catholic
 
Protestant
 
An Orthodox Church such as the Greek or Russian Orthodox Church
 
Muslim
 
Seventh-Day Adventist
 
Christian Scientist
 
Hindu
 
Buddhist
 
Other (please specify)
 
 
 
Do you happen to be a member of a church, synagogue, mosque, or some other organized religious group?
 
Yes
 
No
 
 
Have you attended church, synagogue, mosque, or some other religious worship service in the last seven days?
 
Yes
 
No
 
 
What is your ethnicity?
 
Hispanic origin or descent
 
Black
 
Latino
 
Asian
 
Oriental
 
Polynesian
 
Middle Eastern
 
Jewish
 
Other