Town of Bridgewater Grocery Store Survey

Question Title

1. What is your gender? (Required.)

Male

Female

Question Title

2. What is your age group? (Required.)

16-25

26-35

36-45

46-55

56-65

66-75

76-85

86+

Question Title

3. Which of the following best describes your race? (Required.)

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

Question Title

4. Which of the following best describes your work status? (Required.)

Employed Full-Time

Employed Part-Time

Unemployed/Currently looking for work

Retired

Full Time Student

Part Time Student

Homemaker

Question Title

5. How many people live in your household? (Required.)

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

6. Are you the parent of any children under the age of 18 who currently live with you? (Required.)

Yes

Town of Bridgewater Grocery Store Survey

Question Title

* 1. What is your gender? (Required.)

Question Title

* 2. What is your age group? (Required.)

Question Title

* 3. Which of the following best describes your race? (Required.)

Question Title

* 4. Which of the following best describes your work status? (Required.)

Question Title

* 5. How many people live in your household? (Required.)

Question Title

* 6. Are you the parent of any children under the age of 18 who currently live with you? (Required.)

1. What is your gender? (Required.)

2. What is your age group? (Required.)

3. Which of the following best describes your race? (Required.)

4. Which of the following best describes your work status? (Required.)

5. How many people live in your household? (Required.)

6. Are you the parent of any children under the age of 18 who currently live with you? (Required.)