Thank you for taking our short survey. By answering these questions, you are helping Family Energy serve you better and provide you with the information in which you are interested.

Questions marked with a * are required.

*1 Do you rent or own your home?
Own
Rent
*2 Do you own a (check all that apply):
Dog
Cat
Bird
Fish
None
Other: 
*3 Which of the following items are you likely to purchase in the next year (check all that apply)?
House
Car
Major Appliances
Computer
Stereo
Television
Fine Jewelry
Garden Supplies
Vacation Travel
Business Travel
Small Appliances/Kitchen Supplies
Household Furniture
Office Furniture
*4 Do you own any of the following (check all that apply):
Desktop PC
Laptop
Cell Phone
Personal Digital Assistant (such as a Palm Pilot)
Digital Camera
Video Camera
Photo Scanner
Flat Screen Monitor
*5 Do you plan to purchase any of the following in the next six months (check all that apply):
Desktop PC
Laptop
Cell Phone
Personal Digital Assistant (such as a Palm Pilot)
Digital Camera
Video Camera
Photo Scanner
Flat Screen Monitor
Software
*6 Where do you purchase clothing (check all that apply)?
Discount stores (Target, Walmart)
Department stores
Specialty stores (Gap, Bannana Replublic)
Boutiques
Online
Other: 
*7 How many cars do you own in your household?
1
2
3
4 or more
*8 What type of car do you own (check all that apply)?
Compact
Mid-size
Sedan
SUV
Mini-van
Truck
None of the above
Other: 
*9 Do you plan on buying a car?
In the next 6 months
In the next 12 months
Don't know
*10 How many videos/DVDs do you own?
1-5
5-10
10-15
15-20
More than 20
*11 How many family trips do you take each year?
None
1
2-3
More than 3
*12 What are your areas of interest (check all that apply)?
Clothing
Cars
Beauty Products
Pregnancy/Baby Items
Electronics
Entertainment
Food/Beverage
Financial
Fitness
Home Improvement
Healthcare
Holiday Products
Pets
Travel
Toys
Other: 
*13 How many people have or will you share your issue of Family Energy with?
0
1
2
3
4
5 or more
14 What is you gender?
Female
Male
15 What is your age?
Under 18
18-24
25-34
35-44
45-54
55 or older
16 What is your employment status?
Employed full-time
Employed part-time
Self-employed
Homemaker
Student
Not employed
17 What is your annual household income (USD) ?
Under $15,000
$15,000 - $24,000
$25,000 - $34,000
$35,000 - $49,000
$50,000 - $75,000
$75,000 - $100,000
Over $100,000
18 What is your occupation?
Professional (Doctor, lawyer, CPA, etc)
Technical (Engineer, data processor, architect, computer programmer, etc.)
Executive
Owner/Proprietor
Public official/administrator
Teacher
Nurse/Other health care
Civil/Government worker
Clerical/Secretarial
Salesperson
Factory worker
Artist/Craftsperson
Service worker (Waiter, gas station attendant, cook, etc)
Other: 
19 Are you pregnant?
Yes
No
20 How many children do you have?
0
1
2
3
4
5 or more
*21 Please enter your email to be entered into the drawing for prizes:
22 Please enter your full name, address and phone number below.