Basic Demographics example
This is an example Basic Demographics survey. This survey includes questions like:
Are you Male or Female?
What is your age?
What is the highest level of education you have completed?
We hope this will help you create your own Basic Demographics survey. We
have not tested the validitiy or reliability of this survey. However, you may
use this as a starting point to help your own survey instrument. Feel free to
change and edit any of our survey templates to help you get started.
1) Are you Male or Female?
Select one...
Male
Female
2) What is your age?
Select one...
18-21
22-25
26-30
31-40
41-50
51-60
61 or over
3) What is the highest level of education you have completed?
Select one...
Less than High School
High School/GED
Some College
2-Year College Degree(Associates)
4-Year College Degree(BA,BS)
Master's Degree
Doctoral Degree
Professional Degree(MD,JD)
4) What is your own yearly income?
Select one...
Less than $10,000
$10,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
$50,000-$59,999
$60,000-$69,999
$70,000-$79,999
$80,000-$89,999
$90,000-$99,999
$100,000-$149,000
More than $150,000
5) What is your total household income, including all earners in your household?
Select one...
Less than $10,000
$10,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000-$49,999
$50,000-$59,999
$60,000-$69,999
$70,000-$79,999
$80,000-$89,999
$90,000-$99,999
$100,000-$149,000
More than $150,000
6) What is your current marital status?
Select one...
Single, Never Married
Married
Separated
Divorced
Widowed
7) What is your religious affiliation?
Select one...
Protestant Christian
Roman Catholic
Evangelical Christian
Jewish
Muslim
Hindu
Buddhist
Other
8) What is your race?
Select one...
White
White, non-Hispanic
African-American
Hispanic
Asian-Pacific Islander
Native American
9) What is the highest level of education your mother has completed?
Select one...
Less than High School
High School/GED
Some College
2-Year College Degree(Associates)
4-Year College Degree(BA,BS)
Master's Degree
Doctoral Degree
Professional Degree(MD,JD)
10) What is the highest level of education your father has completed?
Select one...
Less than High School
High School/GED
Some College
2-Year College Degree(Associates)
4-Year College Degree(BA,BS)
Master's Degree
Doctoral Degree
Professional Degree(MD,JD)
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