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2013
April
T
Test Survey
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SheLoves Basic Survey
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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.
I Agree
What is your gender?
Male
Female
What is your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
Please describe your current residence:
Owned by you or someone in household with a mortgage or loan
Owned by you or someone in household free and clear (no mortgage or loan)
Rented
Occupied without payment of rent
How many children do you have?
no children
1 child
2 children
3 children
more than 4 children
Please select your Hobbies and Interest
Auto racing
Biking
Boating
Bowling
Camping
Crafts
Dancing
Fine Arts
Fishing
Gambling
Gardening
Hiking
Hunting
Horseback riding
Kayaking
Martial Arts
Music
Photography
Reading
Sports
Travel
Other
Please rank (1-3) the following in order of interest:
Skiing
-- Select --
1
2
3
Snowboarding
-- Select --
1
2
3
Biking
-- Select --
1
2
3
How satisfied are you with the following:
Very Unsatisfied
Unsatisfied
Neutral
Satisfied
Very Satisfied
Website
Customer Service
Overall
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