First
name: |
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Last name: |
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Address 1: |
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Address 1: |
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City: |
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State/Province: |
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Zip/Postal Code: |
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Country: |
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1. Do you, or anyone in
your household, drive a car? |
Yes No
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(If you answered "no" to
the question above, please skip to question
7)
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2. What brand car do you
drive?
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Make:
Model:
Year:
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3. How often do you drive
your car?
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Rarely
Once
a week
Several
times a week
Daily
Several
times a day
I
drive on the job
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4. What do you think is
the most important feature in an automobile?
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Comfort
Safety
Performance
Looks
Good
Value / Price
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5. Have you, or anyone in
your household been involved in an
automobile accident in the last three years?
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Yes No
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6. Considering the vehicle
you or someone in your household currently
drives, would you say that this vehicle is
safe?
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Yes No
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7. On a scale of 1 to 5,
how would you rate the importance of safety
in a vehicle for you or your family?
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1 - Not Important
2
- Somewhat Important
3
- Important
4
- Extremely Important
5
- My top concern
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8. Would you be interested
in purchasing a vehicle equipped with a new
type of safety device?
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Yes No
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9. What is your opinion of
the term "Active Safety System"?
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Dislike
No
Opinion
Like
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10. Would you pay more for
a car equipped with an "Active Safety
System" than for one without?
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Yes No
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Thank you
for completing the survey!
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This Window ]
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