This form is anonymous and will be used solely to appropriately identify customer demographics as part of market research. The information gathered will be used to refine my intended target market to create a better business strategy moving forward. If, for any reason, you do not feel comfortable answering the questions, please leave blank or choose "Prefer not to answer." If you have any concerns regarding this questionnaire, please email
Please select your age category. *
To which gender do you most identify? *
Please select your highest level of education completed. *
Please select what best describes your personal income level (prior to COVID-19, if applicable). *
In what community do you live? *
In what TYPE of community do you live? *
In what community do you work? *
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