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* 1. How much does your household spend in an average week on groceries? (check one)

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* 2. Where do you spend most of your grocery dollars? (check one)

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* 3. From the list below, please choose the top three factors you consider when choosing where to shop for groceries:

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* 4. Please rate the performance of your primary grocery store in meeting your needs in the following categories:

  Excellent Good Fair Poor
Quality/freshness of products
Prices
Location of store/convenience
Hours of operation
Atmosphere/ambiance of store
Cleanliness of store
Knowledgeable staff
Friendly/courteous staff
Carries brands my family likes
Availability of natural/organic foods
other (please specify)
How well does the store meet your needs overall?

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* 5. Do you have any comments regarding how your primary grocery store is meeting your needs?

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* 6. If Glenn heights were to establish a CO-OP grocery store, how important would these features rank as an incentive to become a member and shop at this store?

  Very important Important not important No opinion
Member ownership of the store
Selection of organic foods
Patronage refunds for members
Location of the store
Store design and atmosphere 
Ability to vote for board of directors
Charitable contributions
Locally produced products
Other....Please specify

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* 7. Please indicate your level of agreement with the following statements.

  Agree Somewhat agree Somewhat disagree Disagree
I exercise on a regular basis
Nutritional value is more important to me than price when buying food
Organic foods are very important to me and my family
I am proactive about my health
I buy local foods when available
I shop in places where I feel a sense of community
As much as possible, I shop at locally owned retailers
I am willing to pay a little more for products that are produced more sustainably/ with less environmental impact
I engage in activities that address political/social issues

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* 8. What is your gender?

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* 9. What is your age range?

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* 10. How far do you travel (one way) to shop at your preferred grocery store?

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* 11. What is your approximate annual household income?

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