OPERATIONS RESEARCH (BUS2)

Marketing Feasibility Survey Intake Sheet: Mushroom Bagoong

Please spare a few minutes of your time to answer the simple questionnaire. Thank you.

Please put a check on your answer (√).

NAME: _________________________________________ AGE: _________

GENDER: female □ male □

ADDRESS: ______________________________________ BARANGAY: _______________

MONTHLY INCOME: (PHP): ______________

WORK / PROFESSION: ____________________ OTHER SOURCE OF INCOME::____________________

RELIGION/RELIGIOUS AFFLIATION: ___________________

EDUCATIONAL ATTAINMENT: _______________________

NUMBER OF FAMILY MEMBERS: _____________________

EDUC.
CIVIL STATUS MONTHLY INCOME
NAME: RELATIONSHIP AGE ATTAIN. OCCUPATION
Survey:

1) Personally, I have tasted bagoong. YES □ NO □

2) Type of bagoong I had tasted: Alamang □ Isda □ Tausi □

Other , please specify: ________________

3) I have allergy or diagnosed of allergy with bagoong: YES □ NO □

4) I was rushed in the hospital for consuming bagoong YES □ NO □

5) Personally, I have tasted mushroom. YES □ NO □

6) I have allergy or diagnosed of allergy with mushroom: YES □ NO □

7) Type of mushroom I had tasted: Oyster Mushroom □ Button Mushroom □

Shitake Mushroom □ Other please specify: ________________

8) I have used mushroom in cooking dishes like pasta. YES □ NO □

9) I am familiar with mushroom products. YES □ NO □

10) Source of information about edible mushroom or mushroom products.

Family & Friends □ Social Media Ads (Facebook IG Twitter etc.) □ School □

TV & Radio Ads □ Personal Research □ other please specify: _________ N/A: □

11) The type of mushroom-processed products I had tasted for the past 5 or 10 years.

· Mushroom Bagoong □ Tapa Mushroom □

· Jam/ Marmalade □ Other, pls. specify: ____________

· Mushroom atsara □

12) The mushroom brand I bought was : _____________ N/A: □

14) I bought mushroom products from online seller/reseller:
YES □ NO □

15) Location of the Mushroom Product Brand:

16) Frequency of eating mushroom products:

Frequently: □ Often: □

Never: □ Tried Once or Twice: □

17) I know the nutritional facts of eating mushroom. YES □ NO □

18) Given a chance I will try the Mushroom Products. YES □ NO □

19) Given a chance I will try the Mushroom Bagoong (made with Alamang): YES □ NO □

20) Given a chance I will try the Mushroom Bagoong (made with Tausi): YES □ NO □

21) Given a chance the Mushroom Bagoong flavor I will choose is:

Plain □ Spicy □ Sweet □

Garlic □ Extra Spicy □ Sour □

22) My family members will be interested with the mushroom bagoong if ever they will try it.
YES □ NO □

If yes. Please site the reason: ___________ If No. Please site the reason:_____________

Name of Enumerator: ______________________________________ Date: __________

Name and Signature of Respondent: _________________________________________

Approved by : ________________________________________

CSJDM STAFF