Online Survey Questionnaire is a very effective tool used by most organizations to gather information related to varied purposes. The data so gathered is assembled, processed and then used as per the needs of the surveyor. This tool is used by many business institutes or by governmental organizations to understand the market trend related to some specific point.

Sample Online Survey Questionnaire


The below given is a sample of a demographic survey conducted by government.

1)   Provide names and Social Security Number of all adult members (age above 18) in the household-




2)   What is the mean age of all the people in the household?

a)   0 to 18 years

b)   19 to 24 years

c)   25 to 35 years

d)   35 to 65 years

e)   Above 65 years

3)   Total number of males ______

4)   Total number of females ____

5)   Contact of the head of the family


6)   Average education level of all the members in the household

a)   Below Xth standard

b)   Below XIIth standard

c)   Graduate

d)   Post Graduate

7)   Number of persons in the household who are full time employed _____

8)   Number of persons in the household who are part time employed _____

9)   Number of persons in the household who are self employed _____

10)               Number of persons in the household who are unemployed _____

11)               Is there any person in the household who is physically disabled?

a)   Yes

b)   No

If YES, please provide their names and the impairment


12)               The average annual income of the household is

a)   Below $10,100

b)   $10,000 to $30,000

c)   $40,000 to $70,000

d)   $70,000 to $100,000

e)   Above $100,000