Candy Survey
When was the last time you purchased the followings for yourself?
Today or Yesterday
Last Week
Last Month
Last 3-6 Months
Over 6 Months
Don't Know/Never
Individual size chocolate candy (candy bars etc.)
1
2
3
4
5
6
Individual size non-chocolate candy (fruit flavored candy etc.)
7
8
9
10
11
12
Chewing gum
13
14
15
16
17
18
Breath mints
19
20
21
22
23
24
Flavored chewy candy
25
26
27
28
29
30
Where do you purchase the candy bar from?
Candy Store
Gas Station
Grocery Store
Dept. Store/Target/Walmart
Other
Please select three brands of candy you frequently purchase:
Altoids
Breath Savers
Certs
Eclipse Mints
Ice Breakers Mints
Junior Mints
LifeSavers
Mentos Mint Chews
Skittles
Starburst
Tic Tac
Other
Please select three brands of gum you frequently purchase:
Big Red
Dentyne
Eclipse Gum
Extra
Ice Breakers Gum
Mentos Gum
Orbit
Stride
Trident
Winterfresh
5 Gum
Other
What's the most you would pay for your favorite candy bar?
3 for $1
2 for $1
$1 for Each
$2 for Each
$3 for Each
$4 for Each
More than $4 for each
Other
Have you ever given or received candy as a gift?
Yes
No
Not Remember
Yor gender
Female
Male
Prefer not to answer
Other
Your age
Younger than 12
12-15
16-20
21-30
31-40
41-50
51+
Prefer not to answer
Your current employment status?
Full-time
Part-time
Homemaker
Full-time student
Currently unemployed
Retired
Unsure
Prefer not to answer
Other
Do you currently have any of the followings?
Special diet
Food allergies
Dietary restrictions due to lactose intolerance
Diabetes
Food sensitivities
Strict weight management program
None of them
Submit
Should be Empty: