11/14/02 #75207068 ID# 

BUSINESS OPPORTUNITY STUDY (0 1-05) 

SCREENING QUESTIONNAIm 

MARKET: 

1 Arlington 

2 Austin 

3 Boston 

4 St. Charles 

5 Colorado Springs 

6 Edison 

(08) (09) 

Quota Groups 

AGE GENDER 

7 Los Angeles 1 18-29 1 MALE 

8 Poughkeepsie 2 30-44 2 FEMALE 

9 Schenectady 3 45-59 

10 Seminole 4 60 and over 

11 Toledo START: 

12 Wichita STOP: 

LENGTH: 

I CHECK QUOTAS I 

/ SIGHT SCREEN FOR MALES AND FEMALES 18 YEARS OF AGE OR OLDER I 

Hello, T'm from U.S.Research, a nationwide market research company. I assure you 

that we are not selling anything ... all we want are your honest opinions. Could you spare us a few 

minutes to answer some brief questions? 

A. Do you currently operate a small business or venture to earn money or supplement your 

income? 

I YES (GO TO QC) 

2 NO (CONTINUE) 

B. How interested are you in starting a small business or venture to earn money or 

supplement your income? Are you (MAD LIST. CIRCLE ONE RESPONSE) 

I very interested, (CONTINUE) (1 1) 

2 interested (CONTINUE) 

3 slightly interested, or (TERMINATE AND TALLY) 

4 not interested (TEMINATE AND TALLY) 1 2 3 4 5 6 7 8 9 10 (12-13) 

Do you or does anyone in your household work .. . 

In marketing research? 

In advertising or public relations? 

For a company that markets new business opporlunities? 

In the accounting or financial services field? 

For a store in this shopping mall? 

IF YES TO ANY OF THE ABOVE, 

TERMINATE AND TALLY 1 2 3 4 5 6 7 8 9 10 
D. During the past six months, have you padicipated in any market research survey other 

than a political poll? 

1 YES (TERMINATE AND TALLTO 1 2 3 4 5 6 7 8 9 10 (16-17) 

2 NO (CONTINUE) (18) 

E. Urhich of these groups includes your age? (READ LIST) 

1 Under 18 (TEWINATE AND TALLY) 1 2 3 4 5 6 7 8 9 10 (1 9-20) 

2 18-29 CHECK QUOTAS (21) 

3 30-44 CHECK QUOTAS 

4 45-59 CHECK QUOTAS 

5 60 and over CHECK QUOTAS 

6 MFUSED (TERMINATE AND TALLY) 1 2 3 4 5 6 7 8 9 10 (22-23) 

OVER QUOTA (TEMINATE AND TALLU) 1 2 3 4 5 6 7 8 9 10 (24-25) 

F. Do you usually wear eyeglasses or contact lenses when you read? 

1 YES (CONTINUE) (26) 

2 NO (ASK QH) 

C. Do you have your eyeglasses or contact lenses with you today? 

1 YES (CONTINUE) 

2 NO (TERMINATEANDTmLY)12345678910 

H. I'd like you to accompany me to the interviewing area where I will show you some 

advertising materials and then ask you some questions about it. We'll be giving you 

$2.00 to thank you for participating. 1 think that you'll find it interesting, and it will take 

only a few minutes. 

Before we continue, J need to obtain your name and telephone number. Uot~ may be 

contacted later to verify that the interview occurred, but infomation you provide will be 

kept confidential and will not be used to sell you anything. 

[IF AGREEABLE, ESCORT TO INTERVIEWING FACILITY. IF QUALIFIED 

BUT REFUSED, TERMINATE AND TALLY] 1 2 3 4 5 6 7 8 9 10 (30-3 1) 

I. MCORD (DO NOT ASK) 

1 MALE CHECK QUOTAS 

2 FEMALE CHECK QUOTAS 

Recruiter's Name: 

Interviewer's Name: 

Editor's Name: 
THIS PAGE WILL BE COMPLETED IN BEN IN FACILITY BEFOm 

INTERVIEW IS CONDUCTED. 

(RESCREEN RESPONDENT). 

PMNT NAME OF RESPONDENT: 

RECORD TELEPHONE NUMBER INCLUDING AREA CODE. 

I 

(If number dialed is a non-working number, terminate and tally by circling lS" 

availablenumber 1 2 3 4 5 6 7 8 9 10 (33-34) 

THIS SECTION MUST BE SIGNED BY PERSON WHO DIALED THE 

I certify that I dialed the number and that it is a working number. 

Name (PNNT): 

Signature: 

Date: