1 Opinion Income-Get Paid For Your Opinion Now!

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This is a sample survey of what you will be paid to participate in.

Survey Topic: Personal Shopping
Number of Questions: 20
Payment for Completing Survey $5.00 (This is only a sample, no compensation for completing this sample)

First Name:
Last Name:
E-Mail:
Address:
City, State, Zip:
Gender:	Male Female
Age:	18-24 25-31 32-40 41 or older
Which grocery store do you most frequently shop at?	Kroger Randall's Albertsons Hughes Ralphs Safeway Stater Brothers Vons Other (please specify)
How often do you shop for groceries per month?	5 times a month 4 times a month 3 times a month twice a month once a month less often than once month
On average, how much money do you spend on groceries in total per month?	under $50 $50 to $100 $101 to $200 $201 to $300 $301 to $400 $401 to $500 $501 or more
Are online grocery shopping services available in your area?	Yes No Don't know
Have you ever shopped online for groceries?	Yes No
When you purchase groceries, do you generally...?	Purchase only items you intended to purchase prior to going to the grocery store Purchase additional items that you see while you are browsing Purchase additional items that you see advertised
Have you ever pulled coupons or special offers from newspapers to use when shopping for groceries?	Yes No
Does the grocery store you visit most frequently offer a frequent shopper program?	Yes No
How would you rate the customer service at the grocery store you frequently shop at?	Excellent Very Good Average Poor
Which pharmacy/drugstore do you most frequently shop at?	Eckerds Longs Osco Rite Aid Savon Walgreen
How often do you shop for pharmacy/drugstore products per month?	5 times a month 4 times a month 3 times a month twice a month once a month less often than once month
On average, how much money do you spend on pharmacy/drugstore products in total per month?	under $50 $50 to $100 $101 to $200 $201 to $300 $301 to $400 $401 to $500 $501 or more
Are online pharmacy/drugstore services available in your area?	Yes No Don't know
Have you ever shopped online for pharmacy/drugstore products?	Yes No
When you purchase pharmacy/drugstore products, do you generally...?	Purchase only items you intended to purchase prior to going to the grocery store Purchase additional items that you see while you are browsing Purchase additional items that you see advertised
Have you ever pulled coupons or special offers from newspapers to use when shopping for pharmacy/drugstore products?	Yes No
How would you rate the customer service at the pharmacy/drugstore you frequently shop at?	Excellent Very Good Average Poor

Thank you for taking the time to participate in our survey about personal shopping.

This is a sample survey of what you will be paid to participate in.

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