Sample recruitment questionnaire for primary market research

1. 1
MartinTrust Center for MITEntrepreneurship – Sample Recruitment
Questionnaire
Recruitment questionnaire
1. What is yourprogram of study?
School:
- School of Architecture andPlanning
- School of Engineering
- School of Humanities,Arts,andSocial Sciences
- SloanSchool of Management
- School of Science
- WhitakerCollege of HealthSciencesandTechnology
Course #:
[fill in]
Undergraduate orGraduate:
- Undergraduate
- Graduate
2. What level of interestdoyouhave inlearningwhatitislike toworkin a startupor to start a
company?Are you veryinterested,somewhatinterested,neitherinterestednordisinterested,
somewhatdisinterested,orverydisinterested?
- VeryInterested
- SomewhatInterested
- NeitherInterestednorDisinterested
- SomewhatDisinterested
- VeryDisinterested
- I Don't Know
3. How likelyare youtostart a companywithinfive yearsof graduatingfromyourcurrentdegree
program?Are youverylikely,somewhatlikely,neitherlikelynorunlikely,somewhatunlikely,orvery
unlikely?
- Verylikely
- Somewhatlikely
- Neitherlikelynorunlikely
- Somewhatunlikely

2. 2
- Veryunlikely
- I Don't Know
4. What level of familiaritydoyouhave withthe MIT EntrepreneurshipCenter?Are youveryfamiliar,
somewhatfamiliar,neitherfamiliarnorunfamiliar,somewhatunfamiliar,or veryunfamiliar?
- Veryfamiliar
- Somewhatfamiliar
- Neitherfamiliarnorunfamiliar
- Somewhatunfamilar
- Veryunfamiliar
5. InformationAboutYou
Name
[fill in]
Email
[fill in]
Gender
- Male
- Female
Weed out criteria:
- Will acceptonlyif Q1 isSchool of Engineering,orSchool of Science,orCourse NumberisMAS
(MediaLab)
- Will accepta 50/50 splitof undergrad/gradanda 50/50 splitof male/female
- Will rejectif Q2 isSomewhatorVeryDisinterested(regardinginterestinstartups)
- Will rejectif Q3 isSomewhatorVeryUnlikely(regardingstartingacompany)
- Will rejectif Q4 isVeryFamiliarorSomewhatFamiliar(regardingfamiliaritywithTrustCenter)
- Will rejectif people givethe “neither”or“I don’tknow”responsesonQ2-3.