An advertising survey questionnaire is normally filled by a consumer and this type of survey is carried out by a research agency on behalf of an organization or their advertising agency. The primary aim of this type of survey questionnaire is to generate awareness among consumers regarding a particular advertisement. This survey also helps in providing valuable information regarding customer choices and their perceptions.

Advertising Survey Questionnaire Sample

Name of the consumer: ________________________________

Age: ______ Sex: _______  Occupation: ______________________

Address: ______________________________________

City: ________________ State: ___________________  Zip: _________________

Telephone: ____________________  Fax: ____________________________

Email: _________________________

Q1. How often do you see the advertisement for ‘abc’ in newspapers and television?

a)   Once in a day

b)   More than 5 times

c)   5-10 times

d)   More than 10 times

e)   Not even once

Q2. How well has this advertisement caught your attention?

a)   Very well

b)   Well enough

c)   Not very well

d)   Not catchy

e)   Don’t remember

Q3. Are the claims made in this advertisement believable?

a)   Very believable

b)   Not believable

c)   Believe in some of the claims

d)   Can’t say

Q4. Did the ad provide relevant information about the product?

a)   Excellent

b)   Very good

c)   Good

d)   Not enough information

e)   No information at all

f)    Can’t say

Q5. How appealing is the advertisement?

a)   Extremely appealing

b)   Very appealing

c)   Not very appealing

d)   Not appealing at all

e)   Can’t say

Q6. Did you find the advertisement convincing?

a)   Very convincing

b)   Convincing

c)   Not convincing enough

d)   Not convincing at all

e)   Can’t say

Q7. How would you rate this advertisement vis-à-vis other advertisements for similar products?

a)   Excellent

b)   Very Good

c)   Good

d)   Bad

e)   Poor

f)    Neutral

Q8. Based on the advertisement how likely would you buy this product?

a)   Very likely

b)   Somewhat likely

c)   Not very likely

d)   Not at all

e)   Can’t say