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Customer Survey (open)

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Customer Survey (open)

Question details
(Required)
Yes
No
(Required)
Which age band best describes you
18-24
25-34
35-44
45-54
55-64
(Required)
Yes
No
(Required)
Yes
No
(Required)
What is your employment status?
Unemployed
Working full-time (30+ hours a week)
Working part-time (less than 30 hours a week)
Student
Housewife
Other
(Required)
(Required)
Please select all that apply
Cycling
Tennis
Golf
Football - playing
Football - watching
Other sport
Reading
Writing
Watching television
Any other hobbies/interest
Comment - if any other hobby/interest please define.
(Required)
Direct Mail
Employer
Exhibiton
Local Authority
Housing Association
Internet
Newspaper/magazine
Radio
Seminar
Television
Signboards
Word of mouth
Other
(Required)
White British
White Irish
White Other
Mixed: White and Black Caribbean
Mixed: White and Black African
Mixed Other
Asian or Asian British Indian
Asian or Asian British Pakistani
Asian or Asian British Bagladeshi
Asian or Asian British Other
Asian or Asian British Caribbean
Black or Black British African
Chinese
Other Ethnic Group
(Required)
What is your combined household income?
Under £10,000
£10,000 - £15,000
£15,000 - £20,000
£20,000 - £30,000
£30,000 - £40,000
Over £40,000
(Required)
If you are employed what is your job title and in which industry do you work?
(Required)
Please select your Borough
Barking and Dagenham
Barnet
Brent
Broxbourne
Dacorum
Enfield
Haringey
Harrow
Hillingdon
Lambeth
Southwark
Tower Hamlets
Waltham Forest
(Required)
What best describes you?
Maried/Living with partner
Single
Seperated
Divorced
Widowed
Other
(Required)
Please select the number of children in your Household
None
One
Two
Three
Four
(Required)
Do you own any of the following, please select all that apply.
Car
Motorcylce
Bicylce
Dog
Cat
Any other pet
(Required)
Do you have internet connection at home, if so please state type:
Standard
Broadband
(Required)
Which best describes your religion or religious demonination?
Christianity
Buddhism
Hindu
Islam
Jewish
Sikh
None
Other
(Required)
Are you a smoker?
Yes
No
(Required)
Please select which are applicable:
Regional/local newspaper
National tabloid newspaper (The Sun, Daily, Star etc)
Ethnic newspaper/magazine
Lifestyle newspaper/magazine
Native language newspaper/magazine
Other
Quick Poll

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