Form 687 2013 687 Dept of State English Questionnaire

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Overview

Foreign Language Translation
Welcome and Thank You Text
BLANK Current Model Qsts
Current CQs

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Sheet 1: Foreign Language Translation

Client Name:
Measure Name:	IIP English
Version of Code:	Please fill in
Custom Qualifier Page	Please Select
Custom Invitation Text?	Please Select
Custom Tracker Text?	Please Select
Custom Welcome/ Thank You Text?	Please Select
Language(s)	If other language not listed, please specify.	Website URL	MID(s) (DOT FILL THIS IN)	Measure Name(s) (DOT WIll FILL THIS IN)	Notes:
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language
Please Select a Language

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Sheet 2: Welcome and Thank You Text

Model Instance Name:
IIP English
MID:	Existing Measure - Please fill in; New Measure - DOT will fill in
Date:	8/29/2013
Welcome and Thank You Text
	Directions:
	This welcome text is shown at the top of the questionnaire window and the thank you text at the bottom. This is a good place to mention the site/company/agency name so the visitor knows whom they are taking the survey for. Feel free to modify the standard Welcome and Thank you text shown in the boxes below. Please read comments before using any of the text.
					Examples
					Welcome Text Example
	Welcome Text
	bharati.hulbanni: if STORES MEASURE: do NOT use any welcome text. Thank you for visiting our site. You've been randomly chosen to take part in a brief survey to let us know what we're doing well and where we can improve. Please take a few minutes to share your opinions, which are essential in helping us provide the best online experience possible.
					Thank You Text Example
	DEFAULT Thank You Text
	bharati.hulbanni: TY text can be used for all measure types (call center, web, stores, mobile etc.) Thank you for taking our survey - and for helping us serve you better. We appreciate your input!
	ALTERNATE WEB Thank You Text
	bharati.hulbanni: Use this TY text ONLY for WEB Thank you for taking our survey - and for helping us serve you better. Please note you will not receive a response from us based on your survey comments. If you would like us to contact you about your feedback, please visit the Contact Us section of our website.

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Sheet 3: BLANK Current Model Qsts

Model Instance Name:
IIP English
MID:		Existing Measure - Please fill in; New Measure - DOT will fill in
Partitioned (Y/N)?
FPI Included(Y/N)?
NOTE: All non-partitioned surveys will NOT be imputed and the elements will be rotated as a default unless otherwise specified and approved by Research.
Date:		8/29/2013
IIP English
Model questions utilize the ACSI methodology to determine scores and impacts
		ELEMENTS (drivers of satisfaction)			CUSTOMER SATISFACTION			FUTURE BEHAVIORS	FPI
	MQ Label			MQ Label			MQ Label		Y?

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Sheet 4: Current CQs

#REF!

red & strike-through: DELETE

IIP English

underlined & italicized: RE-ORDER

MID: Existing Measure - Please fill in; New Measure - DOT will fill in

pink: ADDITION

Date:

8/29/2013

blue + -->: REWORDING

IIP English CUSTOM QUESTION LIST

QID

FPI Y?

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

CQ Label

Innovation Generation content is useful to me.

Strongly disagree

Radio button, one-up vertical

Single

Y

Content

Disagree

Neither agree or disagree

Agree

Strongly agree

The Innovation Generation community is a good place to learn about starting a business.

Strongly disagree

Radio button, one-up vertical

Single

Y

Good Place to Learn

Disagree

Neither agree or disagree

Agree

Strongly agree

I would recommend the Innovation Generation to others.

Strongly disagree

Radio button, one-up vertical

Single

Y

Recommend

Disagree

Neither agree or disagree

Agree

Strongly agree

Have you learned anything from the Innovation Generation community that would help you start your own business?

Never

Radio button, one-up vertical

Single

Y

Learned Anything

Rarely

Sometimes

Often

Always

Innovation Generation is a good place to talk with other people interested in innovation.

Strongly disagree

Radio button, one-up vertical

Single

Y

Talk with Others

Disagree

Neither agree or disagree

Agree

Strongly agree

How often do you interact with Innovation Generation on Facebook?

This is my first time

Radio button, one-up vertical

Single

Y

Interaction

Rarely

Sometimes

Often

Almost every day