Survey
Please take a moment to fill out our survey for a chance to win gift certificates from our advertisers in our monthly online drawing. (This drawing is separate from our print version)
WE MAY ALSO SEND YOU VIA EMAIL INFO UPDATES FROM OUR ADVERTISERS
(YOUR NAME, ADDRESS AND EMAIL WILL BE KEPT STRCTLY CONFIDENTIAL)
FIRST NAME
Male or Female
LAST NAME
ADDRESS
CITY STATE ZIP
EMAIL
YOUR AGE GROUP - (<19) (20/30) (31/40) (41/45) (46/51) (52/62) (60/70) (>70)
HOW LONG (IN YEARS) HAVE YOU LIVED IN THE PEORIA AREA
WHAT CITY/TOWN DO YOU CURRENTLY LIVE
INCOME RANGE (<$30) ($31k to $40k) ($41k to $55k) ($56k to $75k) ($76k to $100k) (>$100k)
ON AVERAGE HOW OFTEN DO YOU DINE BREAKFAST LUNCH DINNER OUT IN A WEEK?
YOUR THREE FAVORATE FOOD TYPES ARE (EXAMPLE - ITALIAN, SEAFOOD, VEGETARIAN )
1 2 3
YOUR THREE FAVORATE RESTAURANTS ARE 1 2 3
FAVORITE PLACE TO SHOP FOR COOKWARE
HOW MANY MINUTES WOULD YOU TRAVEL FOR BREAKFAST LUNCH DINNER
HOW OFTEN DO YOU PURCHASE FLOWERS IN A YEAR?
HOW OFTEN DO YOU PURCHASE A CAR?
WOULD YOU HAVE AN INTEREST IN LEARNING ABOUT PLACES TO EAT AND
THINGS TO DO IN COMMUNITIES 50 MILES FROM PEORIA?
WHAT PRICE REANGE DO YOU TRY TO STAY WITHIN? BREAKFAST LUNCH DINNER
WHERE DO YOU SHOP FOR MEAT? 1 2 3
WHERE DO YOU SHOP FOR PRODUCE? 1 2 3
WHERE DO YOU SHOP FOR GROCERIES?1 2 3
DO YOU PURCHASE ORGANIC FOODS? YES NO SOMETIMES
MY FAVORATE NON-ALCOHOLIC BEVERAGE IS?
MY FAVORATE ALCOHOLIC BEVERAGE IS?
WOULD YOU ATTEND A WINE TASTING?
WOULD YOU BE INTERESTED IN A MONTHLY RESTAURANT LUNCH OR DINING TOUR?
WOULD YOU BE INTERESTED IN A MONTHLY RESTAURANT TASTE TOUR?
WOULD YOU ATTEND A CHEF COOK-OFF EVENT?
WHERE DO YOU GET YOUR DINNING, MARKETS, RESTAURANTS AND FOOD SHOPS INFO? FRIENDS
PHONE BOOK NEWSPAPER TV RADIO DINING & FOOD MAG
WHAT WOULD CAUSE YOU TO TRY A NEW RESTAURANT OR FOOD SHOP?
PRICE LOCATION REVIEW
WHERE DO YOU PICK UP YOUR COPY OF DINING & FOOD MAGAZINE?
WHAT DO YOU LIKE MOST ABOUT DINING & FOOD MAGAZINE?
WHAT DO YOU LIKE LEAST ABOUT DINING & FOOD MAGAZINE?
WHAT DO YOU LIKE TO SEE IN DINING & FOOD MAGAZINE?
REGARDING DINING & FOOD MAGAZINE - DON'T CARE FOR IT MIGHT READ IT AGAIN
DEFINITELY READ IT AGAIN WANT A SUBSCRIPTION
AFTER READING DINING & FOOD MAGAZINE I KEEP IT GIVE TO A FRIEND TOSS IT
DO YOU PICK UP A COPY OF DINING & FOOD MAGAZINE EACH MONTH?
WHAT LOCAL PRINT PUBLICATIONS DO YOU READ? DINING & FOOD MAGAZINE PJ STAR
ARTS & SOCIETY MIDWESTERN FAMILY NEWS & VIEWS IBI
NUMERO HEALTHY CELLS PEORIA PROGRESS
AFTER READING AN ARTICLE ABOUT A BUSINESS IN DINING & FOOD MAGAZINE DO YOU VISIT THEM?
YES NO I PLAN TO SOON
WHAT PERCENT OF DINING & FOOD MAGAZINE DO YOU READ EACH MONTH?
WHY DO YOU READ DINING & FOOD MAGAZINE?
THANK YOU FOR TAKING TIME TO FILL OUT OUR DINING & FOOD MAGAZINE SURVEY.
WE WILL ADD YOUR NAME TO OUR MONTHLY DRAWING AND ANNOUNCE YOU ON OUR MAIN PAGE IF YOU HAVE WON A GIFT CERTIFICATE FROM ONE OF OUR ADVERTISERS.
WE MAY ALSO SEND YOU VIA EMAIL INFO UPDATES FROM OUR ADVERTISERS
PLEASE CLICK ON THE SUBMIT BUTTON TO SUBMIT YOUR SURVEY
(YOUR NAME, ADDRESS AND EMAIL WILL BE KEPT STRCTLY CONFIDENTIAL)
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