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Example Questionnaire
1. Have you ever been to Maryland?
Yes
No
2. Do you like ice cream?
Yes (Go to question 3)
No (Go to question 4)
3. What is your favorite ice cream flavor?
Vanilla
Chocolate
Chocolate Chip Cookie Dough
Cherry Garcia
Other
4. Do you like cake?
Yes
No
5. Please select the statement that you agree with:
I am willing to travel 1 mile to find an ACME Bookstore.
I am willing to travel 3 miles to find an ACME Bookstore.
I am willing to travel 5 miles to find an ACME Bookstore.
I am willing to travel 10 miles to find an ACME Bookstore.
6. The customer care representative was helpful.
| Strongly disagree | Disagree | Neutral | Agree | Strongly Agree |
| 1 | 2 | 3 | 4 | 5 |
7. The customer care representative was...
| Very Much | Somewhat | Neither | Somewhat | Very Much | ||
| 1 | 2 | 3 | 4 | 5 | ||
| helpful | unhelpful | |||||
| friendly | unfriendly | |||||
| polite | rude |
8. For your academic and research endeavors, how often do you use the following types of information?
| Never | Very Frequently | ||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | |
| Information on museums | |||||||
| Information on galleries | |||||||
| Information on specific art collections | |||||||
| Descriptions of works of art (text) | |||||||
| Reproductions of works of art (images) | |||||||
| Biographical information about artists | |||||||
| Biographical information about artists |
9. What methods do you use to purchase flight tickets? (Mark all that apply)
Internet Travel Agency
Non-Internet Travel Agency
Directly with Airline
Other
10. What method did you use the last time you purchased flight tickets?
Internet Travel Agency
Non-Internet Travel Agency
Directly with Airline
Other
11. What is your education level?
1 - High School or lower
2 - Some College
3 - College Graduate
4 - Some Graduate School
5 - Master's Degree
6 - Doctorate
Enter the correct number:
12. Please rank the following the following vegetables from best (1) to worst (5):
Broccoli
Carrots
Potatoes
Arugula
Spinach
13. Do you have any comments for us?