Shopping Research Question Title * 1. Contact Information First and Last Name City State Primary Phone Number Question Title * 2. What is your gender? Female Male Question Title * 3. What is your race? Caucasian African American Asian Hispanic/Latino Other Prefer not to answer Question Title * 4. What age range do you fall in? Under 18 18 - 25 26 - 35 36 - 45 46 - 55 56 - 65 66+ Question Title * 5. What is your household income? Under $25K $25-49K $50-99K Over $100K Prefer not to answer Question Title * 6. How many times in the past month have you shopped for food & beverages on the go or for immediate consumption at each store? 1 time a month 2 - 3 times a month 4+ times a month Grocery Store (Kroger, Albertsons, Publix, etc.) Yes No N/A Grocery Store (Kroger, Albertsons, Publix, etc.) 1 time a month menu Yes No N/A Grocery Store (Kroger, Albertsons, Publix, etc.) 2 - 3 times a month menu Yes No N/A Grocery Store (Kroger, Albertsons, Publix, etc.) 4+ times a month menu Natural Grocer (Whole Foods, Trader Joes, Sprouts, etc.) Yes No N/A Natural Grocer (Whole Foods, Trader Joes, Sprouts, etc.) 1 time a month menu Yes No N/A Natural Grocer (Whole Foods, Trader Joes, Sprouts, etc.) 2 - 3 times a month menu Yes No N/A Natural Grocer (Whole Foods, Trader Joes, Sprouts, etc.) 4+ times a month menu Convenience Store /Bodega (7 Eleven, Circle K, Speedway, etc.) Yes No N/A Convenience Store /Bodega (7 Eleven, Circle K, Speedway, etc.) 1 time a month menu Yes No N/A Convenience Store /Bodega (7 Eleven, Circle K, Speedway, etc.) 2 - 3 times a month menu Yes No N/A Convenience Store /Bodega (7 Eleven, Circle K, Speedway, etc.) 4+ times a month menu Dollar General Yes No N/A Dollar General 1 time a month menu Yes No N/A Dollar General 2 - 3 times a month menu Yes No N/A Dollar General 4+ times a month menu Drug Store (CVS, Walgreens, etc.) Yes No N/A Drug Store (CVS, Walgreens, etc.) 1 time a month menu Yes No N/A Drug Store (CVS, Walgreens, etc.) 2 - 3 times a month menu Yes No N/A Drug Store (CVS, Walgreens, etc.) 4+ times a month menu Aldi Yes No N/A Aldi 1 time a month menu Yes No N/A Aldi 2 - 3 times a month menu Yes No N/A Aldi 4+ times a month menu Target Yes No N/A Target 1 time a month menu Yes No N/A Target 2 - 3 times a month menu Yes No N/A Target 4+ times a month menu Walmart Yes No N/A Walmart 1 time a month menu Yes No N/A Walmart 2 - 3 times a month menu Yes No N/A Walmart 4+ times a month menu Club Store (Sam’s Club, Costco, etc.) Yes No N/A Club Store (Sam’s Club, Costco, etc.) 1 time a month menu Yes No N/A Club Store (Sam’s Club, Costco, etc.) 2 - 3 times a month menu Yes No N/A Club Store (Sam’s Club, Costco, etc.) 4+ times a month menu Question Title * 7. Which one of the following statements best describes your financial situation? I am in a poor financial situation and need to stretch my dollar to make ends meet I am financially secure but I am thrifty because it is the smart thing to do Neither of the above statements Question Title * 8. Which one of the following statements best describes how you shop? I utilize technology for shopping (making lists, finding deals and saving money) I am a creature of habit, I like to go to the same stores and buy my staples I am willing to travel for the lowest prices Question Title * 9. Which one of the following statements best describes how you shop? I generally don’t enjoy shopping so I try to be as efficient as possible I look for the lowest prices at stores that are conveniently located near me I am a prepared and organized shopper (making lists) and I look for coupons in circulars/flyers Done
