1.Tell us about yourself!

Name

Business/Organization

Email Address

Phone Number

2.How many vehicles do you / your household currently own?

1

2

3 or more

3.Have you ever personally owned an electric vehicle?

Yes, a hybrid electric/petrol vehicle

Yes, a fully electric vehicle 

No, I have never owned an electric vehicle

4.Have you ever driven an electric vehicle?

Yes a hybrid electric/petrol vehicle 

Yes, a fully electric car

No, I have never driven an electric vehicle

5.How likely are you to own an electric vehicle in the next 5-10 years?

Very likely

Somewhat likely

Somewhat unlikely

Very unlikely

6.What do you consider the main benefits or advantages of electric vehicles?

7.What do you consider the main disadvantages of electric vehicles?

8.How likely are you to consider buying an electric vehicle in the next 3 years?

Very likely

Somewhat likely

Neither likely nor unlikely

Somewhat unlikely

Very unlikely

Unsure

9.Rate the following on the effectiveness in terms of convincing you to buy an electric vehicles

If there were more charging stations available in my area

If it were easy to find replacement parts (including batteries)

If long-term fuel and maintenance savings outweighed the higher initial asking price 

If the vehicle has good expected resale value

if the battery production was cleaner

If electric vehicles become more mainstream

Very effective 

Somewhat effective 

Not effective 

10.How quickly (hours) would it need to take to fully charge an electric vehicle for you to consider buying one?

11.How far (miles) would you expect to be able to drive an electric vehicle on a fully charged battery for you to consider buying one?

12.If prices for gasoline increased, at what price ($ per gallon) would you be much more likely to consider buying an electric vehicle? 

$3

$4

$5

$6

$7

$8

$9

$10

$10+

$3

$4

$5

$6

$7

$8

$9

$10

$10+

13.On average how many miles do you drive on a daily basis?

Under 20 miles

Between 20 and 50 miles

Between 50 and 100 miles 

Over 100 miles

14.Which of the following age groups are you in?

Under 25 years

25-39 years

40-59 years

60 years or over

15.Is there anything else you would like us to know?