Respondent no: _____|_____|_____

RESPONDENT DETAILS:
Name: ____________________________________

Phone:__|__|__|__-__|__|__|- __|__|__|__|

Address: __________________________________

Date: ________________

Hello, my name is ___________________. I am from ________________, a consumer research firm.

We are conducting a survey among women and I would like to ask you a few questions.
1. Code Gender
Male.................................. 1
Female.............................. 2

TERMINATE
CONTINUE IF APPROPRIATE OTHERWISE
TERMINATE

2. What is your age?

years old.

Under 18 years old

18-24 years old
25-29 years old
30-34 years old
35-39 years old
40-44 years old
45-49 years old
50-54 years old
55-59 years old
60-64 years old
65 years old and over

1
2
3
4
5
6
7
8
9
1
0
1
1

TERMINATE
CONTINUE
(15%
QUOTA)
CONTINUE
(11%
QUOTA)
CONTINUE
(10%
QUOTA)
CONTINUE
(10%
QUOTA)
CONTINUE
(11%
QUOTA)
CONTINUE
(12%
QUOTA)
CONTINUE
(12%
QUOTA)
CONTINUE
(10%
QUOTA)
CONTINUE (9% QUOTA)
TERMINATE

3. Do you, or anyone living in your household work for:

An Advertising Agency
A Market Research company
The media (TV, radio, press)
A Public Relations firm or department
A company involved in manufacturing, retailing or distribution of personal care
products or household products
A company that manufactures Deodorants, flavors or specialty chemicals
None of these

YES
1

NO
0

IF YES TO ANY OF THE ABOVE EXCEPT NONE OF THESE, TERMINATE

4. Are you allergic or have you ever had any allergic reactions to any types of Deodorants or
scents?
Yes....................................
No.....................................

1
2

TERMINATE
CONTINUE

5. Does any of the following physical conditions currently apply to you?

Cold/sinus problems including rhinitis

Asthma
Allergic or sensitive/intolerant to foods
or ingredients
Pregnant and/or nursing/breast feeding
Currently wearing a cologne or
Deodorant
Smoker

YE

IF YES TERMINATE

Interviewer: be careful not to question a

person who strongly smells of tobacco

6. Have you, or any member of your family participated in a marketing research study other
than a political survey within the past 6 months?
Yes..................................... 1
No...................................... 2

TERMINATE
CONTINUE

7. Tell what best describes the extent to which you are involved in the selection of the Deodorants that

you, yourself, use

[Single choice only]

I buy the products myself

I choose the brand that I like and somebody else from my
household buys it.......................................
Somebody else chooses the brand and buys it for me

I use whatever is at hand at the moment

3
2

TERMINA
TE
TERMINA
TE

8. Which category describes your ethnicity? (SELECT ONE)

(64%
QUOTA)
(16%
QUOTA)
(12%
QUOTA)
(5%
QUOTA)
(4%
QUOTA)

White Caucasian (non-Hispanic)

Hispanic or Latino*

African-American (non-Hispanic)

Asian (non-Hispanic)
Other (e.g. other race non-Hispanic,
multiple races non-Hispanic)

9. What best describes the last level of education you completed to date? (SELECT ONE)
Less than High School

High School Graduate

Some College

College Graduate

Graduate School

Professional / Technical Certification

Other

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TERMINATE

10. Tell what best describes your total household income before taxes? (SELECT ONE)
Under $ 20,000...........................
$ 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 or more......................

1
2
3
4
5

(TERMINATE)

6
7
8
9
10

11. What best describes your marital status? (SELECT ONE)

(RECRUIT A MIX)
Single.............................................................
Married..........................................................
Separated/divorced........................................
Widowed........................................................
Other (Specify)...............................................

1
2
3
4
5

12. Mention your working status? (SELECT ONE)

(RECRUIT A MIX)
Working full time................................
Working part time..............................
Homemaker.......................................
Student..............................................
Retired...............................................
Unemployed/looking for a job............
Other (Specify)..................................

1
2
3
4
5
6
7

13. Deodorants you have worn regularly in the past 6 months?

Deodorant
Deodorant
Deodorant
Deodorant
Deodorant
Deodorant
Deodorant
Deodorant
Deodorant
Deodorant

1
2
3
4
5
6
7
8
9

A
B
C
D
E
F
G
H
I
J

10

Deodorant K

Deodorant L

11
12

Deodorant M

Deodorant N

13
14

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Deodorant O

Deodorant P

Deodorant Q

15
16
17

Deodorant R

Deodorant S

Deodorant T

Deodorant U

Deodorant V

18
19
20
21
22

Deodorant W

Deodorant X

Deodorant Y

23
24
25

Deodorant Z

Deodorant A1

Deodorant B1

26
27
28

Deodorant C1

Deodorant D1

Deodorant E1

Deodorant F1

Deodorant G1

29
30
31
32
33

Deodorant H1

Deodorant I1

Deodorant J1

34
35
36

Deodorant K1

Deodorant L1

Deodorant M1

37
38
39

Deodorant N1

Deodorant O1

Deodorant P1

Deodorant Q1

Deodorant R1

40
41
42
43
44

Deodorant S1

Deodorant T1

45
46

- page -

Deodorant U1

Deodorant V1

A celebrity Deodorant not listed here

(Specify)

47
48
49

Other (Specify)

50

13A. And among the different products you just mentioned, which one do you most often wear? (SELECT ONLY
ONE)

13 B. How many bottles of Deodorant do you currently own? (SELECT ONE)

One bottle
Two bottles
Three bottles
Four bottles
Five bottles
More than five bottles

1
2
3
4
5
6

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