Food Co-op Interest Survey
<Co-op Name>
Shopping Patterns
- How much does your household spend in an average week on groceries? (check one)
Under $50 / $51-$75 / $76-$100 / 101-$125 / $126-$150 / $151+ / Don’t Know
O / O / O / O / O / O / O
- Where do you spend most of your grocery dollars? (check one) (Fill in w/local options)
O /
- Buying club
- Limited assortment store
O /
- Existing food co-op in another community
- Local supermarket
O /
- Natural product retailer
- Regional supermarket chain
O /
- Internet/Mail-order
- National supermarket chain
O /
- Convenience store
- Supercenters
O /
- Local grocery store
- Other ______
Note: In the following questions, “primary store” means the place you spend most of your grocery dollars, the outlet you identified in question #2.
- Where do you regularly purchase the following types of products?
Product categories / Don’t buy / Buy mostly in primary store / Buy mostly elsewhere
- Grocery items (cereal, juice, canned goods, etc)
- Dairy (milk, eggs, yogurt, soy, etc)
- Fresh fruits & veggies
- Frozen foods
- Meat, poultry, fish & seafood
- Deli/ready to eat foods
- Beer/wine
- Coffee/tea
- Bread & bakery
- Bulk products
- Other (please specify): ______
- From the list below, please choose the top five factors you consider when choosing where to shop for groceries:
O /
- Product selection/variety
- Cleanliness of store
O /
- Quality/freshness of products
- Knowledgeable staff
O /
- Prices
- Friendly/courteous staff
O /
- Location of store/convenience
- Availability of brands I/my family likes
O /
- Hours of operation
- Availability of natural/organic foods
O /
- Atmosphere/ambiance of store
- Cooperative ownership
O /
- Other (please specify):______
- How much of your grocery dollars does your household spend at your primary storein an average week?
A little (0-25%) / Some (26-50%) / More than half (51-75%) / Almost all (76-100%) / Don’t know
O / O / O / O / O
- On average, how often do you shop at your primary store?
More than 1/week / Once/week / Twice/Month / Once/Month / Less than 1/Month
O / O / O / O / O
Satisfaction
- Please rate your primary grocery store in terms of how well it is meeting your needs with respect to the following store characteristics:
Very Well / Well / Somewhat Well / Somewhat Poorly / Poorly / Very Poorly / No
Opinion
- Product selection/variety
- Quality/freshness of products
- Prices
- Location of store/convenience
- Hours of operation
- Atmosphere/ambiance of store
- Cleanliness of store
- Knowledgeable staff
- Friendly/courteous staff
- Availability of brands I/my family likes
- Availability of natural/organic foods
- Other (please specify):______
- How well does the store meet your needs overall?
- Do you have any comments regarding how your primary grocery store is meeting your needs? [Optional—Data will be evaluated at additional cost to co-op]
- Please rate your primary grocery storein terms of how well it is meeting your needs in the following product categories:
Very Well / Well / Somewhat Well / Somewhat Poorly / Poorly / Very Poorly / No Opinion/ Don’t Buy
- Grocery items(cereal, juice, canned goods, etc.)
- Dairy (milk, eggs, yogurt, soy, etc)
- Fresh fruits & veggies
- Frozen foods
- Meat, poultry, fish & seafood
- Deli/ready to eat foods
- Beer/wine
- Coffee/tea
- Bread & bakery
- Bulk products
- Do you have any comments regarding how your primary grocery storemeeting your needs with respect to the products offered/not offered? [Optional—Data will be evaluated at additional cost to co-op]
- If you are a <name of co-op> member-owner, how important are these features for shopping at <name of co-op>? (If you are not a member-owner, please skip to question # 14.)
Very Important / Important / Somewhat Important / Not Important / No Opinion
- Member-ownership of the business
- Member-owner promotions
- Patronage refund
- Member-owner appreciation days
- Ability to vote for board of directors
- Other (please specify): ______
- Please indicate your level of agreement with the following statements:
Agree / Somewhat
Agree / Somewhat
Disagree / Disagree / No Opinion
- I know how to contact the co-op organizing group
- The organizing group is responsive to my input
- I trust the group to use members’ investments appropriately
- The organizing group is making timely progress
- The organizing group has asked me to volunteer my assistance
- Other (please specify): ______
- Is there anything else you want to say about <name of co-op>? [Optional—Data will be evaluated at additional cost to co-op]
Personal Characteristics
Please tell us a little about yourself by answering the following questions.
- Please indicate your level of agreement with the following statements:
Agree / Somewhat
Agree / Somewhat
Disagree / Disagree
- I exercise on a regular basis.
- Nutritional value is more important to me than price when buying food.
- Organic foods are very important to me and my family.
- I am proactive about my health.
- I buy local foods when available.
- I shop in places where I feel a sense of community.
- As much as possible, I shop at locally owned retailers.
- I am willing to pay a little more for products that are produced more sustainably/with less environmental impact.
- I engage in activities that address political/social issues.
- What is your gender?
Male / Female
O / O
- What is your ZIP code? ______
- What is your age range?
18 – 24 / 25 - 30 / 31-34 / 35-39 / 40-44 / 45-49 / 50-54 / 55-64 / 65+
O / O / O / O / O / O / O / O / O
- Are you a member of a food co-op other than <name of co-op>? Which one?
Not a member / Am a member
O / O
Name of Co-op ______City ______State ______
- Are you a member-owner of <name of co-op>?
Not a member / Am a member
O / O
- Including you, how many of the following live in your household?
None / 1 / 2 / 3+
- Adults (18+ years old)
- Children
- How far do you travel (one way) to shop at your preferred grocery store?
Less than 1 mile / 1 – 5 miles / 5.1 – 10 miles / 10.1 – 25 miles / 25+ miles
O / O / O / O / O
- What is your highest level of education?
O / Less than high school diploma / O / 2-year college/tech/trade school degree
O / High school diploma / O / 4-year college degree
O / Some college/tech/trade school / O / Graduate/Professional degree
- What is your approximate annual household income?
O / Less than $15,000 / O / $50,000 - $74,999
O / $15,000-$24,999 / O / $75,000 - $99,999
O / $25,000 - $34,999 / O / $100,000 - $149,999
O / $35,000 - $49,999 / O / $150,000 or more
- Please tell us your ethnicity:
O / Asian American / O / Hispanic or Latino(a)
O / Black or African American / O / Native American/Alaskan Native
O / White or Caucasian / O / Two or more/multiple race
O / Other
Communication
- Please list up to three each of your favorite T.V. programs, radio stations, newspapers and websites.
Favorite T.V. programs / ______
______
______
Favorite radio stations / ______
______
______
Favorite newspapers / ______
______
______
Favorite websites / ______
______
______
- How important to you are the following sources of information about <name of co-op>? Note: In the last column, please indicate your 3 preferred ways to get information from <name of co-op>.
Very Important / Important / Somewhat Important / Not Important / No Opinion / Check
top 3
- Local postings (signs, bulletin board, flyers, pamphlets, etc.)
- Co-op website (including blog)
- Informal conversations (with co-op board or staff)
- Formal meetings (annual mtg, Board of Director meetings/listening sessions)
- Emails
- Mailings (co-op newsletter, annual report, special mailings)
- Other (please specify): ______
- Howimportant to you are the following types of information?
Very Important / Important / Somewhat Important / Not Important / No Opinion
Co-op news and information:
- Board of directors news
- Community events (e.g. festivals, celebrations)
- Co-op progress reports
- Financial information/reports
- Other (please specify): ______
Information about foods and products:
- Health and nutrition information
- Food production practices (e.g. genetically modified organisms; organics/organic standards)
- Locally produced products
- Food preparation & recipes
- Food safety
- Other (please specify): ______
Social and agricultural issues:
- Fair trade
- Producer profiles
- Livestock treatment
- The environment
- Other (please specify): ______
- Howsatisfied are you with <name of co-op>’s current delivery of this information to you?(optional)
Very Satisfied / Satisfied / Somewhat Satisfied / Somewhat Dissatisfied / Dis-satisfied / Very Dissatisfied / No Opinion
Co-op news info:
- Board of directors news
- Community events (e.g. festivals, celebrations)
- Co-op progress reports
- Financial info/reports
- Other (please specify): ______
Information about foods and products:
- Health/nutrition info
- Food production practices (e.g. genetically modified organisms; organics/ organic standards)
- Locally produced products
- Food prep & recipes
- Food safety
- Other (please specify): ______
Social and agricultural issues:
- Fair trade
- Producer profiles
- Livestock treatment
- The environment
- Other (please specify): ______
This completes our survey. Thank you for your participation—your feedback
is critical to our ability to serve you well.
Copyright 2008 by National Cooperative Grocers Association.