Completing the survey may take 10-15 minutes
The Questionnaire has a maximum of 3 sections and answering all the displayed sections is mandatory
Inappropriate/Incomplete answers may disqualify you from being select for the prize.
About Yourself
Please provide us your valid
Email ID
, Name and Contact Number so as to make it possible for us to contact you for post-survey validation call and announcing winner of the prize among all the participants of this survey. Please be rest assured that your Email ID, name and telephone number will be
kept confidential
and will not be used for any other purpose than contacting you.
Email Id
Name
Contact Number
Gender
Select One
Male
Female
Age
Select One
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99
Do you stay in a village (rural area) or a town/city (urban area)?
Select One
Village (rural area)
Town/City (urban area)
State
Select One
Andaman & Nicobar Islands
Andhra Pradesh
Arunachal Pradesh
Assam
Bihar
Chandigarh
Chhattisgarh
Dadra & Nagar Haveli
Daman & Diu
Delhi
Goa
Gujarat
Haryana
Himachal Pradesh
Jammu & Kashmir
Jharkhand
Karnataka
Kerala
Lakshadweep
Madhya Pradesh
Maharashtra
Manipur
Meghalaya
Mizoram
Nagaland
Orissa
Pondicherry
Punjab
Rajasthan
Sikkim
Tamil Nadu
Tripura
Uttar Pradesh
Uttaranchal
West Bengal
District
Select One
City/Town
Select One
Any other City/Town
Type of house you live in
Select One
Pucca House
Semi Pucca House
Kutcha House
Land owned by you
Select One
Don't own any land
Upto 2 acres
2 to 5 acres
More than 5 acres
Your highest level of education
Select One
Illiterate
School Upto 4 years
School 5-9 years
High School/ Higher Secondary
Intermediate/Senior Secondary
Polytechnic/Diploma
BA
BSc
BCom
BBA
BCA
BE/BTech
LLB
MA
MSc
MCom
CA/ICWA/CS
PG Diploma
MBA
MCA
MTech
MBBS
MS/MD
LLM
MPhil
PhD General
PhD Professional
Civil services(IAS/IPS/IRS/IFS)
Other
Current Occupation
Select One
Unskilled worker
Skilled worker
Petty Trader
Shop owners/Trader
Businessman/Industrialist with having no emp
Businessman/Industrialist with 1-5 emp
Businessman/Industrialist with 6-10 emp
Businessman/Industrialist with 10-50 emp
Businessman/Industrialist with 50+ emp
Self-employed professionals
Clerical/Salesman (Salaried)
Supervisory level (Salaried)
Junior Level officers/executives (Salaried)
Middle Level officers/Executives(Salaried)
Senior Level officers/Executives(Salaried)
Student
Housewife
Unemployed (searching for job)
Retired
Unable to work due to health/other reason
Farmer (Owner)
Farmer (Non Owner/Agriculture labourer)
Marital status
Select One
Single/Unmarried
Married without children
Married with children
Separated/Divorced without children
Seprated/Divorced with children
Widow without children
Widow with children
Monthly household income
Select One
Less than Rs 6250
Rs 6250 - Rs 12500
Rs 12500 - Rs 25000
Rs 25000 - Rs 40000
Rs 40000 - Rs 80000
Rs 80000- Rs 100,000
More than 100,000
Prefer not to say
Most expensive vehicle owned
Select One
Bi-Cycle
Motor-Cycle/Scooter
Small Car (Up to Rs.4 lakhs)
Mid-Size Car (Rs.4 to 8 lakhs)
Luxury car (Above Rs. 8 lakhs)
MUV/SUV
Tractor
Others
Don't own a vehicle
Credit card ownership (individual)
Select One
Co-branded
Silver
Gold
Platinum
Titanium
Supplementary Card
Don't Own Credit Card
Mobile phone ownership (individual)
Select One
Basic
Basic+FM
Basic+FM+Camera
Basic+FM+Camera+GPRS
High End
I do not own a mobile phone
CWE is the one who contributes the maximum income towards the household expenses.
Are you the Chief Wage Earner (CWE) of your household?
Select One
Yes
No
Out of the following options of education, which is the one that applies to you?
Select One
Illiterate
School Upto 4 years
School 5-9 years
High School/ Higher Secondary
Intermediate/Senior Secondary
Polytechnic/Diploma
BA
BSc
BCom
BBA
BCA
BE/BTech
LLB
MA
MSc
MCom
CA/ICWA/CS
PG Diploma
MBA
MCA
MTech
MBBS
MS/MD
LLM
MPhil
PhD General
PhD Professional
Civil services(IAS/IPS/IRS/IFS)
Other
Out of the following options of occupation, which is the one that applies to you?
Select One
Unskilled worker
Skilled worker
Petty Trader
Shop owners/Trader
Businessman/Industrialist with having no emp
Businessman/Industrialist with 1-5 emp
Businessman/Industrialist with 6-10 emp
Businessman/Industrialist with 10-50 emp
Businessman/Industrialist with 50+ emp
Self-employed professionals
Clerical/Salesman (Salaried)
Supervisory level (Salaried)
Junior Level officers/executives (Salaried)
Middle Level officers/Executives(Salaried)
Senior Level officers/Executives(Salaried)
Farmer (Owner)
Farmer (Non Owner/Agriculture labourer)
Out of the following options of education, which is the one that applies to the Chief Wage Earner of your household?
Select One
Illiterate
School Upto 4 years
School 5-9 years
High School/ Higher Secondary
Intermediate/Senior Secondary
Polytechnic/Diploma
BA
BSc
BCom
BBA
BCA
BE/BTech
LLB
MA
MSc
MCom
CA/ICWA/CS
PG Diploma
MBA
MCA
MTech
MBBS
MS/MD
LLM
MPhil
PhD General
PhD Professional
Civil services(IAS/IPS/IRS/IFS)
Other
Out of the following options of occupation, which is the one that applies to the CWE of your household?
Select One
Unskilled worker
Skilled worker
Petty Trader
Shop owners/Trader
Businessman/Industrialist with having no emp
Businessman/Industrialist with 1-5 emp
Businessman/Industrialist with 6-10 emp
Businessman/Industrialist with 10-50 emp
Businessman/Industrialist with 50+ emp
Self-employed professionals
Clerical/Salesman (Salaried)
Supervisory level (Salaried)
Junior Level officers/executives (Salaried)
Middle Level officers/Executives(Salaried)
Senior Level officers/Executives(Salaried)
Farmer (Owner)
Farmer (Non Owner/Agriculture labourer)