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Branching: If any of the responses are chosen then Terminate
Do you or does any member of your household work for...
 
An advertising or public relations agency
 
A market research, strategic marketing or opinion company
 
The marketing or market research department of any company
 
A telemarketing firm
 
A food manufacturer or retailer
 
A software, hardware or multimedia company
 
developer or manufacturer
 
Online retailer
 
E-commerce or web development company

 
 

Branching: Discard Retired..


Employment
Do you work full time or part time, outside the home?
 
Full-time [35+ Hours per week]
 
Part-time [15-20 Hours per week]
 
Full-time homemaker
 
Retired
 
 

Branching: High School Graduates and Above


Education
Which of the following best describes the highest level of education completed?
 
Some High School
 
High School Graduate
 
Some College
 
Graduated College
 
Post Graduate
 
 

Family Status
Which of the following statements applies to you:
 
I have children under the age of 6 living at home
 
I have children between the ages of 6 and 17 living at home
 
I have no children under the age of 18 living at home
 
 

Online Services
a. Do you log on and use the Internet by yourself, without help, at either work or home?
 
Yes
 
No
 
 

b. How long have you been using the Internet, by yourself?
 
less than 6 months
 
6 – 12 months
 
1 - 2 year
 
more than 2 years
 
 

c. How often do you use the Internet, not including email, by yourself, either at work or at home?
 
Less than one hour/week
 
1 – 2 hours/week
 
2 – 3 hours/week
 
More than 3 hours/week
 
 

d. On a scale of 1 to 5, with 1 being the least comfortable and 5 being the most comfortable, how comfortable and familiar are you using the Internet, including such things as links, site addresses, or search engines?
Least (1)
2 3 4 Most (5)
 
 
 
* Name
   
Phone
   
* Email Address
   
 
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