Market Research Template

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* 1. How likely is it that you would recommend this product to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

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* 2. In your own words, what are the things that you like most about this new product?

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* 3. In your own words, what are the things that you would most like to improve in this new product?

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* 4. What do you like most about competing products currently available from other companies?

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* 5. What changes would most improve competing products currently available from other companies?

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* 6. Which of the following are reasons that you might purchase this product? Please select all that apply.

It is better quality than something I already use

It It serves a need of mine that is not currently being met

It would make a good gift

I purchased something similar in the past but need to replace it

It is a better price than something I already use

Other (please specify)

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* 7. Which of the following are reasons that you might not purchase this product? Please select all that apply.

I purchased something similar and I am satisfied

I don’t know anyone who would want this

I don’t want something like this

It is too expensive

I don’t need something like this

It is low quality

Other (please specify)

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* 8. If this product were available today, how likely would you be to purchase it instead of competing products currently available from other companies?

Extremely likely

Very likely

Somewhat likely

Not so likely

Not at all likely

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* 9. What is your gender?

Female

Male

Other (specify)

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* 10. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 11. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

White

Black or African-American

American Indian or Alaskan Native

Asian

Native Hawaiian or other Pacific Islander

From multiple races

Some other race (please specify)

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* 12. Are you Mexican, Mexican-American, Chicano, Puerto Rican, Cuban, Cuban-American, or some other Spanish, Hispanic, or Latino group?

I am not Spanish, Hispanic, or Latino

Mexican

Mexican-American

Chicano

Puerto Rican

Cuban

Cuban-American

Some other Spanish, Hispanic, or Latino group

From multiple Spanish, Hispanic, or Latino groups

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* 13. How much total combined money did all members of your HOUSEHOLD earn last year?

$0 to $9,999

$10,000 to $24,999

$25,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $124,999

$125,000 to $149,999

$150,000 to $174,999

$175,000 to $199,999

$200,000 and up

Prefer not to answer

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* 14. Which of the following best describes your current relationship status?

Married

Widowed

Divorced

Separated

In a domestic partnership or civil union

Single, but cohabiting with a significant other

Single, never married

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* 15. How many children age 17 or younger live in your household?

None

More than 4