Survey Topic: Sample

Number of Questions: 20

Payment for Completing Survey: $30 USD

1. Please provide us with your contact information:

Name: Organization: Address: City and State: ZIP Code: E-mail:

2. Do you currently use our "PRODUCT"?

Yes No Don't know

3. Which of our "PRODUCTS" are you currently using?

Brand 1 Brand 2 Brand 3 Brand 4 Brand 5 Other

4. How did you purchase our "PRODUCT"?

Retail Store Direct Mail Catalog Web Company Other

5. Are there features that this product does not have that you would like it to possess?

Yes No Don't know

6. What features does our "PRODUCT" not have that you wish it did?

7. How much did you pay for our "PRODUCT"?

8. How satisfied are you with our "PRODUCT"?

Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied

9. Of the following list of features, please select the top three that would be of interest to you:

Feature 1 Feature 2 Feature 3 Feature 4 Feature 5 Feature 6

10. Of the three features you just listed, please rank them first, second and third in importance to you:

1. 2. 3.

11. Are there any additional features that would be of importance to you?

Additional Feature 1 Additional Feature 2 Additional Feature 3 Additional Feature 4 Additional Feature 5

12. Are there particular features that a product must have for you to purchase it? Please list what they are in order of importance:

Essential Feature 1 Essential Feature 2 Essential Feature 3 Essential Feature 4 Essential Feature 5

13. How much would you be willing to pay for a product with these features ("THE LISTED ABOVE FEATURES")?

14. If the "PRODUCT" was priced at $10 how likely, on a percentage basis, would it be to buy it?

(0% = Not at all likely to buy, 100% = Completely likely to buy)

15. How much do you spend for our ?PRODUCT??

16. What do you think about the price of this "PRODUCT"?

Extremely Low Somewhat Low Just right Somewhat High Extremely High

17. Through what means would you be least likely to purchase this "PRODUCT"?

Retail Direct Mail Mail Order Catalog Classified Advertisement Telemarketer

18. Through what means would you be most likely to purchase this "PRODUCT"?

Retail Direct Mail Mail Order Catalog Classified Advertisement Telemarketer

19. What do you think would be a good name for our "PRODUCT"?

20. Can you please tell us which one of the following possible product names you like the most?

Product 1 Product 2 Product 3 Product 4 Product 5

Thank you for taking your time to complete this survey. Select Submit Survey now to send your responses to us.

 

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