Sample Questionnaire Form
A Sample questionnaire form is a set of various open-ended questions that can be used by any company/organization/institute to get some information from people. These forms are widely used for market surveys, research or analysis purpose and some times by governments to collect various kind of data. A sample questionnaire helps to make an ideal and efficient questionnaire. The questions come with two or more choices and some times in yes/no kind of answers. Below shown is a sample questionnaire form of government survey.
Sample Questionnaire Form
Personal Information
Title (Mr./MRS/Miss)__________________
Full Name___________________________
Sex________________
Date of Birth________________
Age________________________
Work Occupation_____________________
Telephone Number Landline_________Mobile___________
Address____________________________
City/State__________________________
Postal Code_________________________
Background
Ethnicity_________
Language__________
Education (Select) — High School_____College_________University
Marital Status____________
Other Information
Do you have Health Insurance/Cover________
Do you have Ration Card______________
Do you have Television/Internet__________
Driving License__________
Vehicle type______________
Own House/Rental_____________
Are you a permanent resident____________?
Is your area connected with public transport services (Select) ______?
Privacy Statement___________________________
___________________________
____________________________
Submit.
Category: Questionnaire Forms
