Snacks Study

Hello and thank you for being a part of the Q-insights database.

We would like to invite you to participate in an online blog on the topic of snacks.

This will be taking place on June 24th-June 30th and you will be paid $175 via check as a thank you for your time.

If you are interested in participating, please complete this questionnaire.

If you pre-qualify a recruiter will be in touch with you to ask a few additional qualifying questions.

Thank you, QI-Team

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* 1. What is your gender?

Male

Female

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* 2. What is your age?

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* 3. Do you have kids under the age of 18 living in your household?

Yes

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* 4. What are the age and gender of your kids, if any?

	Gender	Age
Kid 1	Kid 1 Gender menu	Kid 1 Age menu
Kid 2	Kid 2 Gender menu	Kid 2 Age menu
Kid 3	Kid 3 Gender menu	Kid 3 Age menu
Kid 4	Kid 4 Gender menu	Kid 4 Age menu

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* 5. Do you, yourself, or does anyone in your household have any dietary restrictions due to? Or are any special diets such as?

Food allergies

Aversion to specific foods, such as pre-packaged foods

Low Calorie

Vegetarian/Vegan

Low sodium

Low sugar

None of the above

Other (please specify)

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* 6. Please tell me to what degree you, yourself, participate in shopping for your household’s groceries and snacks. Would you say you?

Almost always purchase groceries/snacks for the household

Share about equally the responsibility for purchasing groceries/snacks for the household

Sometimes purchase groceries/snacks for the household

Rarely or never purchase groceries/snacks for the household

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* 7. Thinking of the past three months, which of the following products, if any, have you, yourself, purchased?

Candy

Cheese

Crackers

Frozen Sandwiches

Fruit spreads (Jams, Jelly, etc)

Granola Bars

Ice Cream

Peanut Butter

Yogurt

None of these

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* 8. Which of the following cracker brands has child(ren)consumed in the past three months?

Annie's

Goldfish

Horizon

Kashi

Imag!ne

Cheez-It

Doctor in the Kitchen

Blue Diamond Nut Thins

Carr's

Austin

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* 9. Which of the following cracker brands has child(ren)consumed in the past three months?

Nabisco Better Cheddars

Nabisco Cheese Nips

Nabisco Ritz

Nabisco Triscuit

Nabisco Wheat Thins

Simply Balanced

Special K

Luke's

Mary’s Gone Crackers

Keebler Club

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* 10. Which of the following cracker brands has child(ren)consumed in the past three months?

Keebler Toasteds

Keebler Town House

Keebler Wheatables

Bitsy's Brainfood

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* 11. How often in the past month does your child(ren) consumed crackers? Would you say?

Once a day

Several times a week

Once a week

Once every 2-3 weeks

Once a month or less

Never

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* 12. Which of the following stores, would you say you shop at most often for yourself/household regarding snacks?

Kroger/Kroger Banner Stores

Super Stop and Shop/Stop and Shop

Albertsons

Safeway

Kmart/Big K/Super K

King Soopers

Target/Super Target

BJ’s

Food Lion

Giant Eagle

Pathmark

Wegmans

Acme

Giant

Tops

Harris Teeter

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* 13. Into which of the following ranges does your total annual income fall?

Less than $30,000

$30,000 - $39,999

$40,000 - $49,999

$50,000 - $59,999

$60,000 - $69,999

$70,000 - $79,999

$80,000 - $89,999

$90,000 - $99,999

$100,000 - $124,999

$125,000 - $150,000

More than $150,000

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* 14. What level of education have you, yourself, completed? Would you say

Attended high school, but did not graduate

High school graduate

Completed some college

Graduate of a 2 - year college

Graduate of a 4 - year college

Post graduate/study/degree

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* 15. Which of the following best describes your ethnic background? Would you say?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

Other (please specify)

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* 16. What is your current employment status? Are you?

full-time employee

Working part-time

part-time/full-time student

Homemaker

Laid-off / looking for work

Retired

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* 17. What is your contact info

Name

State/Province

ZIP/Postal Code

Email Address

Phone Number