#REF! |
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red & strike-through: DELETE |
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#REF! |
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underlined & italicized: RE-ORDER |
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#REF! |
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pink: ADDITION |
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Date: |
1/4/2010 |
blue + -->: REWORDING |
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#REF! |
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QID (Group ID) |
Skip Logic Label |
Question Text |
Answer Choices (limited to 50 characters) |
Skip to |
Type (select from list) |
Single or Multi |
Required Y/N |
Special Instructions |
25 character limit. Leave blank if you want DOT to fill this part out.
CQ Label |
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How frequently do you visit this site? |
First time |
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Radio button, one-up vertical |
Single |
Y |
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Visit Freq |
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More than once a day |
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Daily |
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About once a week |
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About once a month |
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Every 6 months or less |
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How do you locate content? |
Use the bread crumb |
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Radio button, one-up vertical |
Single |
Y |
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Find Content |
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Use the navigation buttons |
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Use the search feature |
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Use the site map |
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How did you learn about this site? |
Web page ad |
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Radio button, one-up vertical |
Single |
Y |
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Learn |
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Brochure (Print) |
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Email hyperlink |
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Blog |
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Link from another site |
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Internet search engine |
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Word of mouth |
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Did you find what you were looking for? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
OPS Group |
Did you find |
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No |
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Did you come to the Embassy website today to find information about passports or visas? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
OPS Group |
Purpose Passport Visa |
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No |
C |
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C |
What was your purpose for coming to site today? |
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Text area, no char limit |
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N |
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Purpose |
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Where are you located? |
Africa |
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Radio button, one-up vertical |
Single |
Y |
OPS Group |
Location |
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East Asia and Pacific |
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Europe and Eurasia |
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Latin America |
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Middle East and North Africa |
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North America |
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South Asia |
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In what country are you located? |
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Text field, <100 char |
Single |
N |
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Name of Country |
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What is your gender? |
Female |
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Radio button, one-up vertical |
Single |
Y |
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Gender |
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Male |
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Prefer not to respond |
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What is your age range? |
Under 14 |
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Radio button, one-up vertical |
Single |
Y |
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Age |
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14 - 18 |
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19 - 30 |
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31 - 50 |
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Over 50 |
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Prefer not to respond |
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By coming to this website today, did you learn something about life in the United States? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Life |
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No |
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By coming to this website today, did you learn something about U.S. foreign policy? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Policy |
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No |
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Did you learn something today on this website that you will share with someone else? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Share |
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No |
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By coming to this website today, did you learn something about the values of the U.S. people? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Values |
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No |
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Do you read books, newspapers, or magazines from the United States? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Read |
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No |
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Do you watch U.S. television shows or movies? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Media |
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No |
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Do you listen to U.S. music? |
Yes |
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Radio button, one-up vertical |
Single |
Y |
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Learn Music |
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No |
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What is your opinion of the United States. |
Very unfavorable |
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Radio button, scale, no don't know |
Single |
Y |
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Opinion |
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Somewhat unfavorable |
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Somewhat favorable |
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Very favorable |
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Please indicate your level of agreement with the statement, "The United States is a trustworthy partner for your country." |
Strongly Disagree |
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Radio button, scale, no don't know |
Single |
Y |
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Trustworthy |
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Disagree |
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Neither Agree nor Disagree |
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Agree |
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Strongly Agree |
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Please indicate your level of agreement with the statement, "The United States treats your country with respect." |
Strongly Disagree |
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Radio button, scale, no don't know |
Single |
Y |
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Treat with respect |
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Disagree |
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Neither Agree nor Disagree |
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Agree |
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Strongly Agree |
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To what extent do you think the United States listens to the views of other countries? |
Not at all |
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Radio button, scale, no don't know |
Single |
Y |
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Listen to views |
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Not very much at all |
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A fair amount |
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A great deal |
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