This survey template provides examples that can be used to collect information from customers at a grocery store. The survey includes questions about shopping frequency, store preferences, attribute importance when choosing a store, ratings of store characteristics, opinions on various lifestyle topics, and demographic information. It also includes an observation form that can be used to evaluate the customer service and store environment at a specific grocery store location.

1. SURVEY TEMPLATES THAT YOU CAN USE
By
Garvin Boonsong-
http://www.linkedin.com/in/garvinboonsong
(626) 607-4349, garvingaryboonsong@gmail.com

2. Villa Market Grocery Survey
This survey is for a class project in Consumer Insight for a Masters Degree in Integrated
Marketing Communication at Dhurakij Pundit University (DPU) International College
1. Have you gone to a grocery store at least once a month?
a. Yes
b. No
2. How many times a month do go grocery shopping?
a. 0-2
b. 3-5
c. 5-7
d. More than 7
3. How many times in the past month have you gone in the following grocery store in the past
month?
0-2 3-5 6-7 More than 7
Market
Tops
Villa
Gourmet
Foodland
Tesco

3. Lemon Farm
4. Assign 20 points among the following attributes when choosing a grocery store? (The higher
the number, the more important the attribute when choosing the grocery store)
a. Convenient Hours
b. Price of Products
c. Quality of products
d. Variety of products
e. Selection of Wine
f. Customer Service
g. Availability of Parking
h. Overall store atmosphere
5. Please rate the following stores on the following characteristics?
a. 1- Poor
b. 2- Fair
c. 3- Good
d. 4- Excellent
e. 5- No known
Convenient Price of Quality of Variety of Wine Customer Availability Overall
products products Selection Service of Parking Grocery Store
Hours products atmosphere
Market
Tops

4. Villa
Foodland
Gourmet
Market
Lemon
Farm
6. Please give your opinion on how important these things are important to you
1. Not At All Important
2. Somewhat Unimportant
3. Neutral
4. Somewhat Important
5. Extremely Important
1) Eating Organic/ pesticide free
2) Doing things to minimize impact on environment
3) Traveling
4) Exploring different cultures
5) Making a lot of money
6) Trying different types of food
7) Exploring and practicing your form of spirituality or religion
8) Exercising regularly
9) Spending time with friends and family
10) Achieving career goals
11) Overall life happiness
12) Wearing name brand clothing
13) Having nice cars, nice house

5. 7) What is your gender? 1) Male 2) Female
8) Were you born in Thailand? A) Yes B) No
9) What is your age group?
a) 16-25 b) 26-35 c) 36-45 d) 46-55 e) 56+
10) What is your income range per month?
1. 0- 10,000 baht/month
2. 10,001 -20,000 baht/month
3. 20,001-25,000 baht/month
4. 25,001-35,000 baht/month
5. more than 35,000 baht/month

6. SAMPLE SURVEY
Observation Form for Villa Market (Re-do this, to correct, re-collect info)
Name of Retailer: __________________________
Date of Observation: ____________ Time: __________ Shopper’s Name: _______________
A. Customer Relations
1. Did employee notice and greet you immediately?
2. Did the employee speak pleasantly and smile?
3. Did the employee answer the telephone promptly?
4. Did the employee find out your name?
5. Did the use your name when speaking to you?
6. Was the employee helpful?
7. Did the employee show genuine interest in you?
8. Did the employee thank you for coming in?
9. Did the employee handle interruptions effectively?
B. Physical Location of the Grocery store
1. Was the location clearly marked with signs from the outside?
2. Was the entrance neat and inviting?
3. Did someone greet you when you entered?
4. How long did it take for someone to ask if they could help you?
5. Were there clear signs about where one should go?
6. Were prices clearly marked on items or shelves?
7. Was the place clean and neat throughout?
8. Were the restrooms clean and fully stocked?
9. Was the music appropriate to the location?
10. Was the temperature comfortable?
11. Was there a place to sit to rest?

7. Other questions
1. The appearance of store? What is the appearance of the store nice, modern, or modern?
2. What is the range of products? Is there a good range of products?
3. How high are prices?
4. Do they have different ways to sample?
5. Is there ambiences, things add to the shopping experience?
Discussion Guide for In-dept Interveiw
1. What are most important 5 values in life? What are the 5 things you value most in life?
2. How would you define your personality?
3. Tell me typical work day
4. How would you define your ideal grocery store?
5. Define or describe the worst grocery shopping experience?)
6. When I say wine what words, emotions, come up?
7. Word association
• When you think of Tesco supermarket what words and emotions come up?
• When you think of Villa supermarket what words and emotions come up?
• When you think of Tops supermarket what words and emotions come up?
• When you think of Foodland supermarket what words and emotions come up?
8. What are things that a store can do to make you want to come back to store?
9. What are things that a store can do to make you not want to come to store?

8. SAMPLE SURVEY
Paso Robles Tourism Survey
Place Where Survey Took Place:_________________________
Date____________________ Survey #___
1. What is your age: a) 18-25 b) 25-34 c) 45-54 d) 55-64 e) 65- 74 f) 75 and
older?
2. What is your marital status? a) Single b) Married
3. What is your education level: a) High school or less b) Some college/technical/vocational
d) College graduate e) Post-graduate
4. In what city, state and/or country is your home? city ________ state/(country)
_________ zip code________
5. Which of the following statements best describe your visit to Paso Robles?
a) The primary destination for your trip
b) A place to visit while traveling through to another destination; (Please
specify end destination)
6. How much time will you/did you spend in the Paso Robles area?
7. How many total nights will you spend during this trip (this question if #5.b was
answered)
8. What was your primary reason for visiting Paso Robles?
9. Have you visited the Paso Robles Region before? Yes No
10. (if yes on #9) How many times you have visited the Paso Robles region in the past 5
years?
A) 1, b) 2-5, c) 6-10, d) more than 20 e) don’t’ know
11. (if #10 was answered) How long ago was your most recent visit to the Paso Robles
region?
12. When did you plan your current visit to the Paso Robles region?
A) within one week B) within one month C) within 3 to 6 months D)
within one year E) beyond one year
13. What were the leisure activities that you engaged in during your visit to Paso Robles
(check all that apply)?
1. Golf 9. Shopping
2. Wine Tasting 10. Museums

9. 4. Water Sports 11. Watchable wildlife
5. Spectator Sports 12. Ballooning
6. Performing Arts, Theater, or
Concerts
13. Dining
7. Spectator Event or Festival 14. Hot Springs
8. Hearst Castle
14. If wine tasting is selected on question 13: ask;a) How would you classify your knowledge
level of wine and the production of wine?
i. Highly knowledgeable ii. Knowledgeable iii. Limited
knowledge iv. No knowledge
b) How would you classify your interest level in learning about wine and the
production of wine?
i. Highly interested ii. Interested iii. Limited interest iv. No
interest
15. Which of the following modes of transportation did you use during this trip?
1. car 7. other, please describe
2. rental car
3. own RV
4. airplane
5. tour bus
6. train
16. How many total traveling in your group? (check all that apply)
total number in party:_____
spouse
children
other relatives
friends
business associates
17. Approximately how much money did you and your party spend in the
Paso Robles Region on:
116
A. Food: $___________
B. Transportation/gas: $___________
C. Shopping: $___________
D. Entertainment and other
activities: $___________
E. Wineries and wine related items $__________
18. What type of accommodations did you use? (circle one)
i. Hotel
ii. Bed and Breakfast

10. iii. Friends or Family
iv. Camping/RV
v. Other
I am now going to ask you some general questions about travel
19. On a scale of 1 – 10, 10 being the greatest. Which of these factors best motivate you
to travel
to a specific destination?
Importance Rating
1. Scenic beauty and natural attractions
2. An opportunity to get away from people
3. The availability of quality hotels and restaurants
4. The cost associated with travel and accommodations
5. The availability of educational opportunities such as historic
sites
6. The availability of direct airline flights to the destination
7. The opportunity for recreational activities
8. The availability of good shopping
9. The desire to visit family and friends
10. The availability of attractions geared toward children
.
20. I’d like to know your opinions about travel packages. Do you prefer to take vacations
that are part of a complete package or do you need to plan all aspects of your trip so that they fit
your personalneeds?a. prefer travel packages b) plan trip c) both d) don’t know
21. On a scale of 1 – 10, 10 being the greatest.
Which of these features would you say can best describe Paso Robles?
Feature Rating Feature Rating
Scenic Beauty Good for
families and kids
Romantic Appealing
climate
Excellent wineries
and vineyards
Nearby beaches
Good restaurants Easy to get
around
Relaxing Convenient to
get to
Outdoor activities Affordable
Great shopping
Safe place to

11. vacation
Comfortable
accommodations
22. How did you first learn about the Paso Robles area? (check/circle all that apply)
1. Print Media 2.ad 3. Article 4.Travel agent 5. Previous personal experience 6. Broadcast media
(Television, Radio) 7. Friends and Family/ word of mouth. 7. Live close by 8. Business trip 9.
Other: please specify. 10. Broadcast media (radio, TV) 11. Don’t know. 12. World Wide web
13.Wine bottle/label 14.Tourism/Visitor Center 15.Travel books
23. When you think of the Paso Robles Region, what positive images come to mind (can
use adjectives) ?
24. When you think of the Paso Robles Region, what negative images come to mind (can
use adjectives) ?
25. How would you rate your stay in the Paso Robles Region on a scale of 1 to 10, with
10 being extremely satisfied?
26. If you rate your stay below 10, what could make a future stay a “10”?
27. Will you visit the Paso Robles region again? If so, when will you plan to visit?
a) 1- 3 months b) 4 – 6 months c) within 1 year c) 1
year and beyond

12. SAMPLE SURVEY
QUESTIONNAIRE: FACTORS INFLUENCING DECISION MAKING OF CURRENT DPUIC STUDENTS
This questionnaire is a partial fulfillment of the requirements for the degree of Master Arts in Integrated Marketing
Communications, Dhukrakij University International College. The data collected through these questions will be
used to understand the current undergraduate and graduate students at DPUIC. This information obtained will be
used for academic purpose only
Remark This questionnaire consists of four parts:
Part 1: Personal information
Part 2: IMC tools
Part 3: Customer satisfaction
Part 4: Decision making
Created by IMC Master student Garvin Boonsong
Email:gpsGarvin@yahoo.com
_______________________________________________
PART 1: PERSONAL INFORMATION
Instruction: Please fill in the following the information
1) What is your gender a) Male b) Female
2) What is your age? ____________ years old
3) What is your class level? a) Undergraduate b) Master’s Degree d) Doctorate
4) What is your major at DPUIC? (Please circle one)
Undergraduate Graduate Doctorate
• Information Technology • Integrated Marketing • Business Administration
Communications (IMC) (DBA)
• English for Business
Communications • Business Administration • Business Informatics
with concentration in IMC
• Hospitality and Tourism • Strategy and Intelligence
Management • Business Administration (PhD)
Double Degree
• International Businesses
• Business Informatics
• Strategy and Intelligence

13. 5) Where are you from? Country______ City______
6) Where are you currently living? Country______ City______
7) Do you work? A) no b) part time (1-20 hours a week) c) Full time (more than 20 hours)
8) If you work what type of job do you do?
a) Private employee b) Private Business c) Government/State enterprise employee 4) Other (please
specify_________)
9) What is your occupation?
a) Health Care b) Engineer c) Science d)Politics e)Education f ) Sports g)Sales h)Marketing i)IT and
Technology k)Management l) HR m)Other_____
10) What is your monthly income?
a) less than 15,000 baht b) 15,000 baht-25,000 baht c) 25,0001-35,000 baht d) 35,0001-45,000 baht e) 45,001-
55,000 baht f) More than 55,000 baht
PART 2: IMC TOOLS
11). Where did you get the information to apply to DPUIC? Please circle all that appliy
a)Parents b) Friends c)Current DPUIC student d)Former DPUIC student e)Exhibition f) DPUIC Website g)Boss
h)Brochures i)Print Ad k)Radio l)Facebook m)Newspaper n)Member of Industry

14. 12). Please rate the following Integrated Marketing (IMC) tools to its influence on you to your decision to come
to DPUIC on a scale of 1 to 5 below:
5: Very important
4.: Important
3: Moderately important
2: Not important
1: Not important at all
LEVEL OF IMPORTANCE
Advertising
a) Print 1 2 3 4 5
b) Radio 1 2 3 4 5
c) TV 1 2 3 4 5
d) Billboard 1 2 3 4 5
e) Catalog 1 2 3 4 5
f) Brochure 1 2 3 4 5
g) Flyer 1 2 3 4 5
Public Relations
(PR)
a) Trade show 1 2 3 4 5
b) Sponsorship 1 2 3 4 5
c) Newspaper 1 2 3 4 5
d)Magazine/Journal 1 2 3 4 5
article
Online
a) Website 1 2 3 4 5
b) Blog 1 2 3 4 5

15. c) Twitter 1 2 3 4 5
d) Facebook 1 2 3 4 5
e) Other Social 1 2 3 4 5
Networks
Personal Selling
Front line Staff 1 2 3 4 5
Administrator 1 2 3 4 5
Professors 1 2 3 4 5
Sales Promotion
Scholarship 1 2 3 4 5
PART 3: CUSTOMER SATISFACTION
13. Please rate the following statement on a scale of 1 to 5 below:
5: Strongly agree with
4: Agree with
3. Neither agree or disagree
2: Disagree with
1: Strongly disagree with
LEVEL OF AGREEMENT
Professors and Staff at DPUIC
DPUIC professors are knowledgeable about their subjects 1 2 3 4 5
DPUIC professors are update to the latest knowledge 1 2 3 4 5
DPUIC professors care for students as individuals 1 2 3 4 5
DPUIC staff is extremely helpful and nice 1 2 3 4 5
Teaching Organization
DPUIC class size allows me to learn optimally 1 2 3 4 5
DPUIC has classes that meets my schedule 1 2 3 4 5

16. University Environment
DPUIC has extra circular activities interaction that supplement learning 1 2 3 4 5
DPUIC provides students with exposure to meet people with real world business people and 1 2 3 4 5
academic
DPUIC provides opportunity to work people from different fields and majors 1 2 3 4 5
University Facilities
DPUIC has books, magazines and other resources that supplement my learning 1 2 3 4 5
DPUIC has activities interaction that supplement my learning 1 2 3 4 5
DPUIC has modern classrooms with adequate class room technologies 1 2 3 4 5
14. Please rate your satisfaction towards the following characteristic of DPUIC on a scale of 1 to 5 below:
5. Strongly satisfied
4. Satisfied
3. Neither satisfied or disatsified
2. Dissatisfied
1. Strongly dissatisfied
Quality of Professors 1 2 3 4 5
Service of Staff 1 2 3 4 5
Teaching Organization 1 2 3 4 5
School Environment 1 2 3 4 5
School Facilities 1 2 3 4 5
PART 4: DECISION MAKING
15. Please check all the reasons why you came to DPUIC
To advance in current career
To start a business

17. To change a career
Personal enrichment
To enter a first career
To make more money
Required or recommended by employer
To keep up to date in current career
16. Who influenced you to come to DPUIC? (Please circle all that apply)
a) Parents b)Friends c) Current College Students d) Former College Students
17. Please rate the factors that you have considered when making a university choice to attend on a scale of 1 to
5 below:
5: Very important
4.: Important
3: Neither important nor not important
2: Not important
1: Not important at all
Closeness to home 1 2 3 4 5
Tuition costs 1 2 3 4 5
Reputation of institution 1 2 3 4 5
Reputation of professors 1 2 3 4 5
Size of university 1 2 3 4 5
Class Size 1 2 3 4 5
18. Please rate the following people who influence on your decision to come to DPUIC on a scale of 1 to 5 below
5: Very important
4.: Important
3: Neither important nor not important
2: Not important

18. 1: Not important at all
Parents 1 2 3 4 5
Friends 1 2 3 4 5
Current College Student 1 2 3 4 5
Former College Student 1 2 3 4 5
Boss 1 2 3 4 5
19) Knowing what you know now, would you go to DPUIC a) yes b) no
20) If you didn’t go to DPUIC, please circle the top 3 universities would you go to in Thailand?
a) Asian b)Assumption c)Chulalongkorn d)Kasem Bundit e)Dusit Thani f)Mahidol
University University University University College University
g)Ramkhamhaeng h)Rangsit i)Sasin Graduate k)Siam l)Sripatum m)Stamford
University University Institute University University International U.
n)Thammasat o)Webster p)Western q)Thailand r) Other
University University University Chamber of
Thailand Thailand Commerce (Please specify)