Basic Demographics example

This is an example Basic Demographics survey. This survey includes questions like:

We hope this will help you create your own Basic Demographics survey. We have not tested the validitiy or reliability of this survey. However, you may use this as a starting point to help your own survey instrument. Feel free to change and edit any of our survey templates to help you get started.

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1) Are you Male or Female?
  • Male
  • Female
2) What is your age?
3) What is the highest level of education you have completed?
4) What is your incoming and your total household income?
Your income
Total household
5) What is your current marital status?
  • Single, Never Married
  • Married
  • Separated
  • Divorced
  • Widowed
6) What is your religious affiliation?
  • Protestant Christian
  • Roman Catholic
  • Evangelical Christian
  • Jewish
  • Muslim
  • Hindu
  • Buddhist
  • Other:
7) What is your race?
8) What is the highest level of education your parents have completed?
Mother
Father
9) If you wish to join our mailing list, please enter your information below: 
Name:
Company:
Address:
Address 2:
City:
State:
Zip:
Email:
Phone:
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