A demographic data questionnaire is used by government to establish specifics about the population. Most of the most common demographic categories in such questionnaires include ethnic origin, race, age and sex. The data generated from such surveys is then used for planning purposes. Common categories in the demographics data include population, where age, sex, race, marital status and education level is considered. Households are also a common category where the total households are considered for purposes of getting the average household size in a specific community. In the income category things such as household income, net worth, per-capita income and disposable income are considered.
Below is a sample.
Name_____________________________
Street address_______________________
Age______________
Sex_______________
Race______________
Marital status: Married____ Single_____ Divorced_______ Separated_______
Q1. What is your education level?
High school diploma
Bachelor’s degree
Master’s degree
Doctorate
Q2. What is your average annual household income?
Below $50,000
Between $50,000 and $100,000
Between $100,001 and $200,000
Above $200,000
Q3. How many people live in your house?
Just me
Between 1 and 3
Between 4 and 6
More than six
Q4. Of people living in your household, how many are dependent on you?
(Please specify)_______________
Q5. What is your combined household income $_________
Q6. What is the amount of disposable income available in your household? $________
Q7. How would you rate the net worth of your household? $_____
Q8. What is the per capita income in your household? $_______
Q9. What is the median home value of your current residential house? $_______
Q10. Your current residential house is:
Owner-occupied
Rental
Not purchased but does not pay rent either
Under mortgage
