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General Profiling Questionnaire

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Banking
Home Phone:
Mobile phone:
Which of these ethnic groups do you belong to?
White British
Any other white background
White and Black Caribbean
White and Black African
White and Asian
Any other mixed background
Indian
Pakistani
Bangladeshi
Any other Asian background
Black Caribbean
Black African
Any other Black background
Chinese
Other ethnic group
Prefer not to say
What is your native language?
Arabic
Bengali
Chinese
Dutch
English
French
German
Greek
Hindi
Italian
Japanese
Javanese
Korean
Lahnda
Latin
Lithuanian
Polish
Portuguese
Russian
Spanish
Turkish
Urdu
Vietnamese
Welsh
Other, please specify:
What is your highest level of education?
GCSE’s
BTEC National Diplomas and Certificates
AS-levels
A-Levels
Certificates of Higher Education
Scottish Highers
HNSs and HNDs
Advanced Diploma
NVQs (National Vocational Qualifications)
SVQs (Scottish Vocational Qualifications)
Apprenticeship
Undergraduate
Graduate
Post Graduate (Masters)
Post Graduate (PHDs)
Other, please specify:
Which of the following academic areas are you studying / have you previously studied in?
Accounting
Anthropology
Archaeology
Architecture
Art
Biology
Business
Chemistry
Classics and ancient civilisations
Computer Science
Cultural / ethnic studies
Dance
Design
Economics
Education
Engineering (Civil / Mechanical)
English Language / Literature
Environmental Studies
Film Studies
Geography
Health and Wellbeing
History
International Studies
Journalism / Media studies
Linguistics
Law
Mathematics / statistics
Medicine
Music
Performing arts
Philosophy
Physics
Politics and Political Science
Psychology
Religion and Theology
Sociology
Sports
Other, please specify:
None of the above
What is your socio-economic status?
Upper management, senior executive
Middle management, executive
Small business owner, self employed
Junior Management
Office/Administrative
Other non-manual
Skilled manual labour
Manual Labourer
Student/Student
Housewife/House husband
Unemployed or casual worker
Retired
Do you have a private pension from your job?
Yes
No
What was your position?
Upper management, senior executive
Middle management, executive
Small business owner, self employed
Junior Management
Office/Administrative
Other non-manual
Skilled manual labour
Manual Labourer
Are you the main earner in your household?
Yes
No
What is your personal net monthly salary?
Less than £800
Between £800 and £1500
Between £1500 and £2500
Between £2500 and £3500
Between £3500 and £4500
Between £4500 and £5500
£5500+
Prefer not to say
What is the net monthly income of your household?
Less than £1000
Between £1000 and £2000
Between £2000 and £4000
Between £4000 and £6000
Between £6000 and £8000
Between £8000 and £10,000
£10,000+
Prefer not to say
What is the socio-economic profile of the main earner of your household?
Upper management, senior executive
Middle management, executive
Small business owner, self employed
Junior Management
Office/Administrative
Other non-manual
Skilled manual labour
Manual Labourer
Student/Student
Housewife / House husband
Unemployed or casual worker
Retired
Does he/she has a private pension from his/her job?
Yes
No
What was his/her position?
Upper management, senior executive
Middle management, executive
Small business owner, self employed
Junior Management
Office/Administrative
Other non-manual
Skilled manual labour
Manual Labourer
What is your relationship status?
Single
Partnered
Living with partner
Engaged
Married
Divorced
Separated
Widowed
How many people live in your household (including yourself)?
1
2
3
4
5
6 or more
How many children under the age of 18 live in your home?
0
1
2
3
4
5 or more
What type of property do you live in?
Apartment/Flat (including student accommodation, studio)
Terrace house
Town house/Semi-detached house
Detached house
Bungalow
Movable dwelling (houseboat, mobile home, caravan, etc)
Hostel/Hotel
Other, please specify:
Do you have a private garden?
Yes
No
Do you:
Own your house
Rent your house
Live with your parents
Share a rented house with friends
Other, please specify:
Do you have a second home?
Apartment / Flat (including studio, student halls)
House
Other
No
Which of the following do you plan to do in the coming year?
Buy an existing house (previously owned)
Buy a newly-built house
Spend more than £10,000 on home improvement
Sell my current house
Stop renting my current house
Rent a different house
Move back home with my parents
Other, please specify:
None of the above
What areas of your house are you planning on improving?
Kitchen
Bathroom
Living room / lounge
Dining room
Bedrooms
Garage
Outside (entrance/terrace/garden)
Other, please specify:
Are you responsible for the grocery / food shopping in your household?
Yes
Occasionally
Jointly responsible
No, I don’t do the grocery / food shopping
How many shopping loyalty cards do you own?
None
1 or 2
From 2 to 5
From 5 to 10
More than 10
Do you own any of the following pets?
Dog
Cat
Rabbit/Bunny
Guinea-pig/Hamster
Mouse/Rat
Bird
Fish
Horse/Pony
Turtle
Snake
Lizard
Pig
Goat
Chicken
Other, please specify:
I don't have any pet
We would like to gather some more information about the child(ren) living in your household. Please complete the following fields :
What is your current sight condition?
I wear glasses all the time
I wear glasses from time to time (to read, in front of a computer, to drive, etc.)
I wear contact lenses
I had a laser operation
Other, please specify:
I do not have any sight problem
Do you smoke?
Yes, cigarettes
Yes, rolling tobacco
Yes, cigars
Yes, other
No, I do not smoke
Which of the following health conditions do you suffer from?
Allergy
Back pain
Diabetes
Food intolerance
Gastric condition
Heart disease
High cholesterol
Hormonal condition
Infections
Insomnia
Kidney condition
Lung condition
Migraine
Musculoskeletal conditions
Obesity
Oral / Dental
Psychiatric
Skin / Hair condition
Urinary
Visual condition
Prefer not to say
Other, please specify:
None of these
Which of the following medical devices do you use?
Blood glucose meter
Braces / Retainers
Dentures
False teeth
Crutches / Cane / Walker
Wheelchair
Hearing aids
Inhalers
Insulin injections
Nicotine replacement therapy products (gum, patches, etc.)
Pacemakers
Prosthetic device
Partial/Full joint replacement
None of the above