Market Survey Template - Field Research

• Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Feedback Form

• Instruction to field researcher: Greet the respondent and ask "do you have a minute to answer a quick survey about online shopping."

• To which age group do you belong?

  Select below 16 16-24 25-34 35-44 45-54 55-64 65 or older

  • below 16
  • 16-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65 or older

• Complete the survey, thank the respondent and find another respondent.

• Do you make online purchases?

  Yes

  No

• What do you usually buy online? (select those that apply)

  Select Food Clothes Gadgets Household items Office supplies Others

  • Food
  • Clothes
  • Gadgets
  • Household items
  • Office supplies
  • Others

• Please describe "Others"

• If an item you plan on buying is available at a physical store, would you prefer buying at a physical store or making your purchase online?

  Online purchase

  Physical store

• Why so?

• Why not purchase online?

• What can help make you more inclined to make purchases online?

Completion

• We appreciate your time!

• (optional) Customer's name and signature

  Sign