DHS CIS DHS CIS Welcome

American Customer Satisfaction Index (ACSI) E-Government Website Customer Satisfaction Surveys

DHS CIS Welcome Questionnaire_Template FINAL.xls

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OMB: 1090-0008

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DHS CIS WelcometoUSA.gov

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MID: Bcgott5xQNwh9kQg8Egpdg==

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Date: 7/20/2009 blue + -->: REWORDING













DHS CIS WelcometoUSA.gov CUSTOM QUESTION LIST
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


How frequently do you visit WelcometoUSA.gov? First time
Drop down, select one S Y


More than once a day






Daily






About once a week






About once a month






Every 6 months or less






Which of the following best describe your role when visiting WelcometoUSA.gov? Legal permanent resident
Radio button, one-up vertical S Y


Naturalized citizen






Individual abroad interested in living in the United States






Individual eligible to naturalize






Community-based organization






Adult educator






Public library






Volunteer






Refugee/asylee






Other, please specify: A




A Other role:

Text area, no char limit
N


Which area of WelcometoUSA.gov are you primarily visiting today? For Receiving Communities
Radio button, one-up vertical S Y


Immigration and Citizenship






Education and Childcare






Healthcare and Families






Government Benefits






About the United States






Money and Finance






Employment






Emergencies and Safety






About Us






Just browsing






Other, please specify: A




A Other area:

Text area, no char limit
N


What is your primary reason for visiting WelcometoUSA.gov today? Find an English class in my area
Radio button, one-up vertical S Y


Download the guide Welcome to the United States






Learn how to apply for U.S. Citizenship






Download the guide to naturalization






Get the latest study materials for naturalization test






Get the Civics and Citizenship Toolkit






Find immigration information






Learn more about government benefits






Learn about the United States






Find information about housing






Get information on health insurance






Learn how to get a green card






Get a driver's license






Other, please specify: A




A Other reason:

Text area, no char limit
N


What method did you use to find information on WelcometoUSA.gov today? Top navigation bar
Drop down, select one S Y


Left-hand advertisement






Right-hand quick links






Links in the page






Site's search feature






Other, please specify: A




A Other method:

Text area, no char limit
N


Did you find what you were looking for? Yes
Radio button, one-up vertical S Y


Partially






No, please specify: A




A Information not found:

Text area, no char limit
N


Please rate how useful is the information provided on WelcometoUSA.gov for the following topics:
Finding a Job
Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Immigration and Citizenship For Immigrants/Permanent Residents Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Adult Education Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Government Benefits Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Naturalization Test Study Materials Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Housing Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Naturalization Information Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Health Insurance Very useful
Drop down, select one S Y Multiple Lists Group


Somewhat useful






Not very useful






Not at all useful






NA






Please rate the variety of the information on WelcometoUSA.gov for the following topics:
Health Insurance
1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group


2






3






4






5






6






7






8






9






10=Excellent






Don't know






Services in your Community 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Finding a Job 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Emergency Information 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Starting a Business 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Family Issues 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Government Benefits 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






About the United States 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Personal Finance 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Housing 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Education for Children 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group


2






3






4






5






6






7






8






9






10=Excellent






Don't know






Please rate how up to date is the information on WelcometoUSA.gov for the following topics:
Health Insurance
1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group


2






3






4






5






6






7






8






9






10=Excellent






Finding a Job 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Emergency Information 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Starting a Business 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Family Issues 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Government Benefits 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






About the United States 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Personal Finance 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Housing 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2







3







4







5







6







7







8







9







10=Excellent







Don't know






Education for Children 1=Poor
Radio button, scale, has don't know S Y Multiple Lists Group



2






3






4






5






6






7






8






9






10=Excellent






Don't know






Don't know






If you could make one improvement to WelcometoUSA.gov, what would it be?

Text area, no char limit
N


Please select the category that includes your age. 17 and under
Radio button, one-up vertical S N


18 - 24






25 - 34






35 - 44






45 - 54






55 - 64






65 and over






I prefer not to respond






In which state do you reside? Outside of US
Drop down, select one S N



Alabama







Alaska







Arizona







Arkansas







California







Colorado







Connecticut







Delaware







District of Columbia







Florida







Georgia







Hawaii







Idaho







Illinois







Indiana







Iowa







Kansas







Kentucky







Louisiana







Maine







Maryland







Massachusetts







Michigan







Minnesota







Mississippi







Missouri







Montana







Nebraska







Nevada







New Hampshire







New Jersey







New Mexico







New York







North Carolina







North Dakota







Ohio







Oklahoma







Oregon







Pennsylvania







Rhode Island







South Carolina







South Dakota







Tennessee







Texas







Utah







Vermont







Virginia







Washington







West Virginia







Wisconsin







Wyoming







I prefer not to respond






What is your country of origin? Afghanistan
Drop down, select one S N



Albania







Algeria







Andorra







Angola







Anguilla







Antigua and Barbuda







Argentina







Armenia







Australia







Austria







Azerbaijan







Bahamas







Bahrain







Bangladesh







Barbados







Belarus







Belgium







Belize







Benin







Bermuda







Bhutan







Bolivia







Bosnia/Herzegovina







Botswana







Brazil







British Virgin Islands







British West Indies







Brunei







Bulgaria







Burkina Faso







Burma







Burundi







Cambodia







Cameroon







Canada







Cape Verde







Cayman Islands







Central African Republic







Chad







Chile







China







Colombia







Congo







Cook Islands







Costa Rica







Côte d'Ivoire







Croatia







Cuba







Cyprus







Czech Republic







Democratic Republic of Congo







Denmark







Djibouti







Dominica







Dominican Republic







East Timor







Ecuador







Egypt







El Salvador







Equatorial Guinea







Eritrea







Estonia







Ethiopia







Falkland Islands







Fiji







Finland







France







French Guiana







French West Indies







Gabon







Gambia







Gaza







Georgia







Germany







Ghana







Greece







Grenada







Guadeloupe







Guatemala







Guinea







Guinea-Bissau







Guyana







Haiti







Holy See







Honduras







Hong Kong







Hungary







Iceland







India







Indonesia







Iran







Iraq







Ireland







Israel







Italy







Jamaica







Japan







Jordan







Kazakhstan







Kenya







Kiribati







Kosovo







Kuwait







Kyrgyz Republic







Laos







Latvia







Lebanon







Lesotho







Liberia







Liechtenstein







Lithuania







Luxembourg







Macao







Macedonia (FYROM)







Madagascar







Malawi







Malaysia







Maldives







Mali







Malta







Marshall Islands







Martinique







Mauritania







Mauritius







Mexico







Micronesia







Moldova







Monaco







Mongolia







Montserrat







Morocco







Mozambique







Namibia







Nauru







Nepal







Netherlands







Netherlands Antilles







New Zealand







Newfoundland







Nicaragua







Niger







Nigeria







North Korea







Norway







Oman







Pakistan







Palau







Panama







Papua New Guinea







Paraguay







Peru







Philippines







Poland







Portugal







Qatar







Romania







Russia







Rwanda







Samoa







San Marino







Sao Tome/Principe







Saudi Arabia







Scotland







Senegal







Serbia and Montenegro







Seychelles







Sierra Leone







Singapore







Slovak Republic







Slovenia







Solomon Islands







Somalia







South Africa







South Korea







Spain







Sri Lanka







St. Kitts and Nevis







St. Lucia







St. Vincent and the Grenadines







Sudan







Suriname







Swaziland







Sweden







Switzerland







Syria







Taiwan







Tajikistan







Tanzania







Thailand







Tibet







Togo







Tonga







Trinidad and Tobago







Tunisia







Turkey







Turkmenistan







Tuvalu







Uganda







Ukraine







United Arab Emirates







United Kingdom







United States







Uruguay







Uzbekistan







Vanuatu







Venezuela







Vietnam







Wales







West Bank







Yemen







Zambia







Zimbabwe







I prefer not to respond




File Typeapplication/vnd.ms-excel
File TitleQuestionnaire Production Guidelines_Template
AuthorProfessional Services
Last Modified Bybjinnohara
File Modified2009-08-25
File Created2001-08-03

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