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Your Name
   
 
 
 
What is your Nationality?
   
 
 
 
Where do you live?
   
 
 
 
Have you ever been to Portugal?
 
This Year
 
Last Year
 
After 2000
 
Before 2000
 
No
 
 
 
Which statement best explains why you are or are not interested in purchasing this product?
 
{REASON 1}
 
{REASON 2}
 
{REASON 3}
 
{REASON 4}
 
{REASON 5}
 
 
How important are each of the following factors when selecting a {PRODUCT/SERVICE NAME}? Please rank in order of importance.
Least important Most important
{FACTOR 1}
{FACTOR 2}
{FACTOR 3}
{FACTOR 4}
{FACTOR 5}
 
 
Would the {PRODUCT/SERVICE} be more or less appealing if it had any of the following attributes?
Much less appealing Somewhat less appealing Neutral Somewhat more appealing Much more appealing
{ATTRIBUTE 1}
{ATTRIBUTE 2}
{ATTRIBUTE 3}
{ATTRIBUTE 4}
{ATTRIBUTE 5}
 
 
 
What would be an appropriate price for this {PRODUCT/SERVICE} if it includes all of the attributes mentioned above?
 
{PRICE 1}
 
{PRICE 2}
 
{PRICE 3}
 
{PRICE 4}
 
{PRICE 5}