THIS IS A FORMAT OF A SAMPLE SURVEY THAT MAY BE CONDUCTED BY AGENCIES. 

This is only a sample form not for public use. 
Columns to fill and answer = 12         Maximum Pay Out = $30      Distribution World Wide. 

 
1. Fill the Personal Details 

Your Name: 

   Your Company Name : 

          Designation 
       
Age - DOB

Postal Address: 
Name of the city

Name Sate

 ZIP/Post Code

      Name of the  Country

E-mail: 
2. Opinion and POLL , Please fill the mark with Ticks By Mouse. 

 Consumer Goods-. 
Are  you using Fast Moving Consumer Goods ? 
Yes I use No I Do not use.    Can't Say 
2.If yes specify the Name of A product you are using.

Please specify the use of that product in 10 words

4. Where do you llook for new Products  
News paper  E Mails Web Sites and Internet Other Resources. 
5.  Cost of product -Range of the price you can afford to buy per month. 

 $300-1000  $1000 -2000  $2000-30000 $3000-40000 $4000 And Above    
Can not say 
6. What do you need to get from a product? The qualities you are looking in a product. Please write in 10 lines or less. Fill below.
7. Any added features you wish to be on them? Specify if any. 
8. What is your income from present Jobs.
  $1000 -2000  $2000-30000 $3000-40000 $4000 And Above   
Can not say
10. How much will you save per month? After TAXES and other expense.
$1000 -2000  $2000-30000 $3000-40000 $4000 And Above   
Can not say
11. Are you satisfied of the products?

  Yes No Can't Say
12. Will you accept a new product in market ?

 I will test them No I will not test nor I will accept I will purchase that and will use Can't say now.

 Please submit the ANSWERS and get the money for participating in survey.
 
Thank you for taking the time to complete this survey. Select Submit Survey now to send your responses to us. Thanks again.
                                   

 

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