Debt Relief: Survey SAMPLE

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Debt Relief Survey Professional Communication ENGL 3106

• We are conducting this survey to gather information about the financial debt problems of the average student. The data that we receive will be processed and our findings will be posted on a website that is being constructed to help students manage their debt. We do not want or need any information other than what is being asked for.

Thank you for your time.

1. How old are you? (circle one) 18-21 22-25 26-30 30+

2. Sex: M F

3. What is your ethnic background? African-American American Indian Asian-American

Caucasian Hispanic-American Other

3. Do you have any credit cards in your name? Yes No If yes, how many? __________

4. Approximately how much total debt has been accumulated on those cards? (circle one) $0-500 $500-1000 $1000-1500 $1500-2000 $2000+

5. Do you have a car payment? Yes No If yes, approximately how much is it per month? __________

6. How much do you spend on miscellaneous or non-essential expenditures per week? $0 – 30 $30 – 70 $70 – 120 $120+

7. Do you rent an apartment or pay a mortgage on a house? Yes No If yes, approximately how much is it per month? __________

8. Do you have any dependents? Yes No If yes, then how many? ______

9. Are you currently employed? Yes No If yes, what is your approximate hourly wage? (circle one) Minimum wage-$7 $7-10 $10-15 $15+

10. Do you currently have any school loans? Yes No

11. Do you currently receive either the HOPE or the Pell Grant? Yes No

12. Do you plan to attend any post-graduate schooling (e.g. law school, medical school, technical school)? Yes No

13. Approximately how much debt do you anticipate having by the end of your education? ___________________________

14. Do you currently have or have recently had any major medical expenses? Yes No

15. Have you received any credit/debt management counseling or aid in the past? Yes No

16. If you knew about a website that gave practical information and options to help you manage your debt would you visit it? Yes No