(Use this template to create a screener survey to send out to people when you're recruiting for your interviews.)
We’re interviewing [gerbil owners]!
We want to learn more about the tools and products that [gerbil owners] use with their [pet gerbils]. We’re looking for [gerbils owners] to participate in a friendly 30-minute phone interview. Every [gerbil owner] that we talk to will receive [an awesome incentive].
Unfortunately, we can’t talk to everyone, so if you’re interested, please answer the questions below. We respect your privacy, and any personal information that you provide in this survey will only be used to select and schedule [gerbil owners] for interviews.
If you have any questions about the [gerbil] interviews we’re looking to conduct, please send an email to [contact email address]. Thanks for your help!
###Demographic Questions
How old are you?
(fill in the blank or provide ranges)
What is your gender?
[] Male
[] Female
[] Other
[] Choose not to answer
How would you describe yourself?
[] African
[] African-American
[] Asian
[] Asian-American
[] Caucasian
[] Hispanic or Latino/a
[] Native American or Pacific Islander
[] Other:
What is the highest level of education that you’ve completed?
[] Didn’t complete high school
[] High school diploma or GED
[] Some college
[] Associate degree
[] Bachelor’s degree
[] Graduate degree
Where do you currently live?
(fill in the blank)
###Specifics
(Choose a few questions specific to what you’re studying. You may need to include questions to screen out people based on skills, experience, tools, etc.)
How long have you been a gerbil owner?
(fill in the blank or date range)
How many gerbils do you currently own?
(fill in the blank or select a number)
What brands of gerbil food do you currently use?
(choose from a list)
###Contact Details (Don’t forget to gather some information for contacting potential participants.)
Your name
(fill in the blank)
Your email address
(fill in the blank)
Your phone number
(fill in the blank)
Are you available for an interview on:
(list out several options for dates and/or times)