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Sample Survey

Survey Subject: Online Shopping
Number of Questions: 28
Payment for Completed Survey: $30.00


E-Mail address

First Name

Last Name

Mailing address

City, State Zip

1. Are you a male or female?
Man
Woman

2. What is your age?
18-24
25-33
34-45
46 or Older

3. How much did you spend online for clothing per month?
Less than $20
$20 - $50
$50 - $100
$101 - $200
$200 - $400
$400+

4. how much money do you spend offline on clothing in total per month?
under $50
$50 to $100
$101 to $200
$201 to $300
$301 to $400
$401 to $500
$501 or more

This is just a small sample of an actual survey. The real surveys are much longer.

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