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Grocery Shoppers - November 2011

Thank you for taking the time to answer these brief questions. As always, we appreciate your input as a valuable Plaza Research respondent. Plaza Research San Francisco is currently looking for Females ages 30-55 for a 4-hour focus group discussion and a homework assignment on the topic of grocery shopping. You will receive a $225 honorarium for your time.

IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone.

Please note that all responses will be returned on a first come, first served basis until the studies are full.

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* 1. Contact information

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* 2. If selected for this study, please indicate ALL the times you are available to participate.

Please keep in mind that all group times have different requirements, so we may not be able to accommodate your first choice. If you are available for all times, please select them all! Thank you!

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* 3. What age range do you fall into?

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* 4. What is your gender?

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* 5. Please indicate your marital status:

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

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* 7. Please indicate your current employment status:

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* 8. Employment Information (if not employed, please write "n/a")...

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* 9. In what range does your total household income fall?

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* 10. Ethnic background

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* 11. Approximately how much of your household's grocery shopping do you personally do?

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* 12. Please list all of the stores you have shopped for food two or more times in the past 2 months?

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* 13. Of the stores you mentioned above, which is your primary grocery store?

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* 14. Which of the following categories of products do you purchase, on average, at least two times a month for yourself or your family? (Select all that apply)

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* 15. Do you, or does anyone in your family, have any food allergies or food restrictions in their diet?

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* 16. Including yourself, how many people live in your household?

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* 17. Do you have any children under 18 living in your household?

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* 18. Which of the following best describes the area in which you live?

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* 19. Do you currently rent or own your home?

**IMPORTANT: PLEASE PUSH THE "DONE" BUTTON AT THE BOTTOM OF THIS SCREEN. YOUR ANSWERS WILL NOT BE SAVED WITHOUT DOING SO!**

Thank you for participating in our survey. IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

*****REFERRALS ARE GREATLY APPRECIATED!*****

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* 20. ******FOR COMPANY USE ONLY******
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