1. How many members currently are living in your household?

1

2

3

4

5+

2. Do you or members of your household purchase carbonated soft drinks?

Yes

No

3. If so, which soft drinks do you or members of your household regularly purchase? (Check all that apply)

Coca-Cola Classic

Pepsi-Cola

Mountain Dew

Dr. Pepper

Sprite

7-Up

Root Beer

Mr. Pibb

Fruit flavored (grape, orange, etc.)

Other

Nobody in my household purchases carbonated soft drinks

4. In what quantity do you usually purchase your soft drinks? (Check all that apply)

Single 20 oz bottle

6 pack of 20 oz bottles

2 liter bottles

12 pack of cans

24 pack of cans

Other

Nobody in my household purchases carbonated soft drinks

5. How often would you say you purchase carbonated soft drinks?

Every day

About twice a week

Once a week

Twice a month

Once a month

Very rarely

Nobody in my household purchases carbonated soft drinks

6. Do you or members of your household purchase bottled water?

Yes

No

7. If so, how often would you say you purchase bottled water?

Every day

About twice a week

Once a week

Twice a month

Once a month

Very rarely

Nobody in my household purchases carbonated soft drinks

8. If not, are there any over-the-counter water filtration devices being used on any of your household faucets?

Yes

No

9. If not currently being used, would you consider using over-the-counter filtration devices on any of your household faucets?

Yes

No

10. Are you or anybody in your household currently members of any “Buy In Bulk” membership stores? (For example: Sam’s Club)

Yes

No

11. Would you consider joining a “Buy In Bulk” membership store if you knew it would save you money in the long run? (For ex: Sam’s Club)

Yes

No

Survey #892: Water and drink purchase habits survey

Number of questions: 11

Compensation: $15

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