SURVEY FORM

Please read each question carefully and indicate your response by selecting the
most appropriate choice.
1. Name:

2. Gender:

Male

Female

3. Age:
4. Education level
Bachelors Degree

Master Degree

Up to High school
5. Occupation:

Business

Professional

Student

Others

Employee

6. Monthly income:
Less than Rs.2000

2000-5000

10000-40000

More than 40000

5000-10000

7. Have you ever had online shopping?

Yes

No

8. How many times did you have online shopping during last one
year?................................................
9. What type of commodity did you purchase through online
shopping?..................................................
10. Have you felt any problem while conducting online purchase?
Yes

No

11. If yes, what kind of problem?

Delay in delivery
Product damage

cheap quality of product

Non-delivery

Others

Please specify..
12. If you never had online shopping, please specify the reason
I dont know about online shopping
transactions

Risk of credit card

Internet illiteracy

Risk of identity theft

Other reasons
13. How often do you use internet every day?
Less than one
2-3 hours

1-2 hours

3-4 hours

More than 4 hours.

14. How often do you use internet for shopping?

Very often
rarely never

often

sometimes

15. Do you use internet prior to a purchase for collecting information?

Yes

No

16. Assuming that you intend to conduct online shopping, which of these purchases would
you make in the internet?
YES
NO
YES
NO
a. Cosmetic/Jewelry

b. Clothes/Shoes

c. CDs/Book
furniture

d. Household

e. Groceries

f. Toys

17. Please select your level of agreement to the following questions.

Strongly Agree
Strongly Disagree
1
5

Agree
2

Indifferent
3

Disagree
4

a. Shopping on internet saves time.

b. It is a great advantage to be able to shop at any time of the day.
c. I prefer traditional/conventional shopping to online shopping.
d. Online shopping is risky
e. A long time is required for the delivery of products and services.