SURVEY QUESTIONNAIRE SAMPLE

Name: Date:
Address:

Part I. Tissue usage habit ( Individual users)

Directions: Answer the following by providing the number of your choice before each questions that
best describe your preferences. Base your choice from the scales provided below. (Isulat ang numero ng
iyong sagot sa blanko bago ang bawat tanong. Ibase ang sagot sa mga iskala na nasa ibaba)
1-Always (Lagi) 3-Seldom (Minsan)
2-Frequently (Madalas) 4-Never (Hindi)
___ 1. In a scale of one to four, how would you rate your need of tissue paper, table napkins or wipes?
___ 2. Do you always include tissue rolls whenever you shop for your household needs?
___ 3. How about tissue paper in plies?
___ 4. Do you consider the tissue brand in choosing your tissue supply at home?
___ 5. Do you check the texture, and color of the brand that you will buy?
___ 6. How about the price? Is it important?

Part II. Tissue Purchase Habit ( Eatery, Coffee shops, Food stalls)
Directions: Answer the following by providing the number of your choice before each questions that
best describe your preferences. Base your choice from the scales provided below. (Isulat ang numero ng
iyong sagot sa blanko bago ang bawat tanong. Ibase ang sagot sa mga iskala na nasa ibaba)
1-Always (Lagi) 3-Seldom (Minsan)
2-Frequently (Madalas) 4-Never (Hindi)

___ 1. Do your customers ask for tissue papers or table napkins after dining in or purchasing items to go
from your stores?
___ 2. Do you have a tissue holder in every table or your stall counter ready?
___ 3. Do you purchase tissue paper in bulk from department stores, intended just for your customers
needs?
___ 4. How about tissue paper in smaller quantity like a 25-ply tissue per pack?
___ 5. Can your business consume 6 (six) or more tissue packs in bulk at 1000-ply per pack a week?
___ 6. Can your business consume 40 (forty) or more tissue paper packs at 25-ply per pack a week?
Part III. General Questions
Directions: Answer the questions by providing the scale of your preference before each number. The
scales are provided below.
1 - Extremely Agree 3 - Disagree
2 - Agree 4 - Extremely Disagree

___ 1. It is preferable to have a tissue manufacturer that provides a delivery service. This will help me
save time and effort in having to go to the nearest grocery whenever I run out of tissue paper stacks.
___ 2. It would be great to have a Bicol-based tissue manufacturing company.
___ 3. I would prefer a tissue brand that clearly makes use of recycled paper as for their main material,
over the commercial brands that focuses on widespread tree-cutting methods in extracting their
materials.
___ 4. A tissue paper that is priced 5(five) to 7(seven) pesos less than the brands I am using before
would be preferable.
___ 5. In general, I will choose a tissue paper brand that provides a door-to-door delivery service of the
product, is priced lower than the usual tissue Im using but of the same quality (color, texture, softness),
makes use of recycled paper instead of giant tree pulps and is a Bicol-based and originated
manufacturer.

THANK YOU VERY MUCH AND HAVE A GOOD DAY!

-The Proponents-