1. Taste Test
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1
. If you qualify and are selected to participate, this study will be held in Irving on Wed. 3/3, Wed. 3/4 or Thur. 3/5 with times set up troughout the day/ evening. Would you be willing to go to Irving for a 1 hour study that pays $70?
If you qualify and are selected to participate, this study will be held in Irving on Wed. 3/3, Wed. 3/4 or Thur. 3/5 with times set up troughout the day/ evening. Would you be willing to go to Irving for a 1 hour study that pays $70?
Yes
No
Not sure, depending on times
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2
. Name
Name
First Name
Last Name
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3
. Gender
Gender
Male
Female
4
. Work Phone Number
Work Phone Number
5
. Cell Phone Number
Cell Phone Number
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6
. Best contact number between the hours of 9am-7pm
Best contact number between the hours of 9am-7pm
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7
. Age
Age
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8
. Email Address
Email Address
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9
. Race
Race
White or Caucasian
Hispanic or Latino
Black or African-American
Asian-American or Pacific Islander
Native American or American Indian
Other (please specify)
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10
. Are you currently a member of our database or was this email forwarded to you by someone else?
Are you currently a member of our database or was this email forwarded to you by someone else?
Current member
Email forwarded
Don’t know
11
. When was the last time, if ever, that you personally participated in a research study of any kind?
When was the last time, if ever, that you personally participated in a research study of any kind?
August 2009 to February 2010
Before August 2009
Don’t Know/Can’t Remember
Never Participated
12
. Which of the following best describes the type of research projects you have participated in since August 2009…
Which of the following best describes the type of research projects you have participated in since August 2009…
Financial Services of any kind
Lap Top Computers
Automobiles
Restaurants of any kind
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13
. How long have you lived in the immediate area?
How long have you lived in the immediate area?
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14
. Within the past year, have you or anyone in your household or anyone in your immediate family been employed in . . .
Yes
No
Marketing or marketing research of any kind
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Within the past year, have you or anyone in your household or anyone in your immediate family been employed in . . . Marketing or marketing research of any kind Yes
Marketing or marketing research of any kind No
Advertising or Public Relations.
Advertising or Public Relations. Yes
Advertising or Public Relations. No
The media: radio, TV, a magazine or newspaper
The media: radio, TV, a magazine or newspaper Yes
The media: radio, TV, a magazine or newspaper No
A restaurant of any type [fast food or sit-down]
A restaurant of any type [fast food or sit-down] Yes
A restaurant of any type [fast food or sit-down] No
A food service manufacturer/distributor of any type of food products
A food service manufacturer/distributor of any type of food products Yes
A food service manufacturer/distributor of any type of food products No
15
. Now I’m going to ask you a few questions about different types of restaurants…
Thinking about Fast Food Restaurants such as Wendy’s, McDonald’s, Jack in the Box, Taco Bell, Sonic, Chik-fil-A, Kentucky Fried Chicken, which of the following best describes, on average, how often you eat lunch, dinner or snacks from any fast food restaurant?
Now I’m going to ask you a few questions about different types of restaurants… Thinking about Fast Food Restaurants such as Wendy’s, McDonald’s, Jack in the Box, Taco Bell, Sonic, Chik-fil-A, Kentucky Fried Chicken, which of the following best describes, on average, how often you eat lunch, dinner or snacks from any fast food restaurant?
Once a week or more
2 or 3 times a month
Once a month
Once every 2 or 3 months
Less than 4 times a year
16
. Thinking about Fast Casual Restaurants such as Chipotle, Café Express, Qdoba, Pei Wei, Potbelly’s, Buffalo Wild Wings, Corner Bakery, Tin Star, which of the following best describes, on average, how often you eat lunch, dinner or snacks from any fast casual food restaurant?
Thinking about Fast Casual Restaurants such as Chipotle, Café Express, Qdoba, Pei Wei, Potbelly’s, Buffalo Wild Wings, Corner Bakery, Tin Star, which of the following best describes, on average, how often you eat lunch, dinner or snacks from any fast casual food restaurant?
Once a week or more
2 or 3 times a month
Once a month
Once every 2 or 3 months
Less than 4 times a year
17
. Thinking about Casual Dining Restaurants such as Applebee’s, Olive Garden, Chili’s, BJ’s, Houlihan’s, On the Border, California Pizza Kitchen, which of the following best describes, on average, how often you eat lunch or dinner from any casual dining restaurant?
Thinking about Casual Dining Restaurants such as Applebee’s, Olive Garden, Chili’s, BJ’s, Houlihan’s, On the Border, California Pizza Kitchen, which of the following best describes, on average, how often you eat lunch or dinner from any casual dining restaurant?
Once a week or more
2 or 3 times a month
Once a month
Once every 2 or 3 months
Less than 4 times a year
18
. Now, thinking about the types of foods you personally order when eating out, for each food category please tell me which word/phrase best describes how often you order that type of food.
Almost Always
Often
Occasionally
Rarely or Never
Entrée Salads
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Now, thinking about the types of foods you personally order when eating out, for each food category please tell me which word/phrase best describes how often you order that type of food. Entrée Salads Almost Always
Entrée Salads Often
Entrée Salads Occasionally
Entrée Salads Rarely or Never
Sandwiches
Sandwiches Almost Always
Sandwiches Often
Sandwiches Occasionally
Sandwiches Rarely or Never
Rice Dishes
Rice Dishes Almost Always
Rice Dishes Often
Rice Dishes Occasionally
Rice Dishes Rarely or Never
Noodle Dishes
Noodle Dishes Almost Always
Noodle Dishes Often
Noodle Dishes Occasionally
Noodle Dishes Rarely or Never
19
. Now, for each of the following types of foods, please tell me how appealing they are to you personally.
One of My Favorites
I like it/ It’s Okay
Don’t Really Care for it
Don’t Know/ Not Sure
Italian Foods
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Now, for each of the following types of foods, please tell me how appealing they are to you personally. Italian Foods One of My Favorites
Italian Foods I like it/ It’s Okay
Italian Foods Don’t Really Care for it
Italian Foods Don’t Know/ Not Sure
Foods made with Pesto
Foods made with Pesto One of My Favorites
Foods made with Pesto I like it/ It’s Okay
Foods made with Pesto Don’t Really Care for it
Foods made with Pesto Don’t Know/ Not Sure
Asian Foods
Asian Foods One of My Favorites
Asian Foods I like it/ It’s Okay
Asian Foods Don’t Really Care for it
Asian Foods Don’t Know/ Not Sure
Southwest or Tex-Mex
Southwest or Tex-Mex One of My Favorites
Southwest or Tex-Mex I like it/ It’s Okay
Southwest or Tex-Mex Don’t Really Care for it
Southwest or Tex-Mex Don’t Know/ Not Sure
BBQ Flavors
BBQ Flavors One of My Favorites
BBQ Flavors I like it/ It’s Okay
BBQ Flavors Don’t Really Care for it
BBQ Flavors Don’t Know/ Not Sure
Grilled Chicken
Grilled Chicken One of My Favorites
Grilled Chicken I like it/ It’s Okay
Grilled Chicken Don’t Really Care for it
Grilled Chicken Don’t Know/ Not Sure
Grilled Steak
Grilled Steak One of My Favorites
Grilled Steak I like it/ It’s Okay
Grilled Steak Don’t Really Care for it
Grilled Steak Don’t Know/ Not Sure
Grilled Salmon
Grilled Salmon One of My Favorites
Grilled Salmon I like it/ It’s Okay
Grilled Salmon Don’t Really Care for it
Grilled Salmon Don’t Know/ Not Sure
20
. Which of the following best describes your employment status?
Which of the following best describes your employment status?
Employed full-time
Employed part-time
Self Employed
Homemaker
Not employed/Retired
21
. Which of the following best describes your marital status?
Which of the following best describes your marital status?
Single
Married or living with partner
Separated, divorced or widowed
22
. To ensure that we’ve spoken to people who represent a range of income levels, please tell me which of the following categories includes your annual household income?
To ensure that we’ve spoken to people who represent a range of income levels, please tell me which of the following categories includes your annual household income?
Less than $30,000
$30,000-$39,000
$40,000-$49,000
$50,000-$79,000
$80,000-$109,000
$110,000-$135,000
Over $135,000
23
. Which of the following best describes your current household?
Which of the following best describes your current household?
At least one child under the age of 5 living in the home
At least one child age 6 to 10 living in the home
At least one child age 11 to 16 living in the home
At least one child age 17 or older living in the home
No children living in the home
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24
. Do you currently have ANY DIETARY RESTRICTIONS such as low-salt, low-fat, low-sugar, low-carb,
Kosher, vegetarian, heart patient, diabetes, OR ANY FOOD ALLERGIES such as nuts, dairy products, fruits or seafood that would prohibit you from tasting a variety of foods?
Do you currently have ANY DIETARY RESTRICTIONS such as low-salt, low-fat, low-sugar, low-carb, Kosher, vegetarian, heart patient, diabetes, OR ANY FOOD ALLERGIES such as nuts, dairy products, fruits or seafood that would prohibit you from tasting a variety of foods?
Yes
No
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