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* 1. What is your gender?

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

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* 3. What is your age?

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* 4. What is your race or ethnicity?

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* 5. What is the highest level of education you have completed?

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* 6. What is your total household income?

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* 7. Which of the following categories best describes your employment status?

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* 8. How often do you attend religious or worship services, not including weddings and funerals?

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* 9. How well do you understand the concept of Islamic Insurance of Takaful?

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* 10. Where did you hear about Islamic Insurance of Takaful? Select all that apply

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* 11. Do you believe that conventional insurance products are Sharia'ah compliant?

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* 12. Do you know that conventional insurance involves interest, uncertainty and gambling which makes it non-Sharia'ah compliant?

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* 13. Do you know that conventional insurance is based on the concept of "contract of exchange" while Islamic Insurance is based on the concept of "mutual cooperation" among participants ?

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* 14. Do you know that, in Takaful or Islamic Insurance, the participants cooperate among themselves against specifics dangers/risks?

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* 15. Do you know that Islamic Insurance Operators distribute the surplus or profit among participants, whereas in conventional insurance profit goes solely to the operators ?

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* 16. Do you know that your contributions will be invested in Sharia’ah compliant investments with Takaful?

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* 17. Do you know that Islamic insurance products include general and family insurance products similar to the conventional insurance?

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* 18. Do you currently have an insurance policy ?

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* 19. Which insurance policies do you currently have? Select all that apply

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* 20. If you do not have LIFE insurance policy, what is the main reason?

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* 21. What makes you interested in buying an insurance policy ?

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* 22. How likely is it that you would choose Islamic Insurance over conventional insurance for your religious belief ?

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* 23. Do you think Islamic Insurance or Takaful has been sufficiently marketed in the USA?

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* 24. In your opinion, what is the most important Islamic Insurance product to offer in the USA? ?

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