Food Co-op Interest Survey
<Co-op Name>
Shopping Patterns
1. 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
2. Where do you spend most of your grocery dollars? (check one) (Fill in w/local options)
O a. Buying club
O b. Limited assortment store
O c. Existing food co-op in another community
O d. Local supermarket
O e. Natural product retailer
O f.
O g. Internet/Mail-order
O h. National supermarket chain
O i.
O j.
Supercenters
O l.
Other ____________________________
Convenience store
O k. Local grocery store
Regional supermarket chain
Note: In the following questions, “primary store” means the place you spend most of your grocery dollars, the outlet
you identified in question #2.
3. Where do you regularly purchase the following types of products?
a. Grocery items (cereal, juice, canned goods, etc)
O
Buy mostly in
primary store
O
b. Dairy (milk, eggs, yogurt, soy, etc)
O
O
O
c. Fresh fruits & veggies
O
O
O
d. Frozen foods
O
O
O
e. Meat, poultry, fish & seafood
O
O
O
f.
O
O
O
g. Beer/wine
O
O
O
h. Coffee/tea
O
O
O
i.
Bread & bakery
O
O
O
j.
Bulk products
O
O
O
O
O
O
Product categories
Deli/ready to eat foods
k. Other (please specify): ________________________
Copyright 2008 by National Cooperative Grocers Association.
Don’t buy
Buy mostly
elsewhere
O
4. From the list below, please choose the top five factors you consider when choosing where to shop for
groceries:
O
a. Product selection/variety
O
b. Cleanliness of store
O
c. Quality/freshness of products
O
d. Knowledgeable staff
O
e. Prices
O
f.
O
g. Location of store/convenience
O
h. Availability of brands I/my family likes
O
i.
O
j.
Availability of natural/organic foods
O
k. Atmosphere/ambiance of store
O
l.
Cooperative ownership
O
m. Other (please specify):_____________________
Hours of operation
Friendly/courteous staff
5. How much of your grocery dollars does your household spend at your primary store in 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
6. 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
7. Please rate your primary grocery store in terms of how well it is meeting your needs with respect to the
following store characteristics:
a. Product selection/variety
Very
Well
O
O
Somewhat
Well
O
Somewhat
Poorly
O
Well
O
Very
Poorly
O
No
Opinion
O
Poorly
b. Quality/freshness of products
O
O
O
O
O
O
O
c. Prices
O
O
O
O
O
O
O
d. Location of store/convenience
O
O
O
O
O
O
O
e. Hours of operation
O
O
O
O
O
O
O
f. Atmosphere/ambiance of store
O
O
O
O
O
O
O
g. Cleanliness of store
O
O
O
O
O
O
O
h. Knowledgeable staff
O
O
O
O
O
O
O
i. Friendly/courteous staff
j. Availability of brands I/my family
O
O
O
O
O
O
O
O
O
O
O
O
O
O
k. Availability of natural/organic foods
O
O
O
O
O
O
O
l. Other (please specify):______________
m. How well does the store meet your
O
O
O
O
O
O
O
O
O
O
O
O
O
O
likes
needs overall?
Copyright 2008 by National Cooperative Grocers Association.
8. 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]
9. Please rate your primary grocery store in terms of how well it is meeting your needs in the following
product categories:
a.
Grocery items (cereal, juice,
canned goods, etc.)
Very
Well
Well
Somewhat
Well
Somewhat
Poorly
Poorly
Very
Poorly
No Opinion/
Don’t Buy
O
O
O
O
O
O
O
b.
Dairy (milk, eggs, yogurt, soy, etc)
O
O
O
O
O
O
O
c.
Fresh fruits & veggies
O
O
O
O
O
O
O
d.
Frozen foods
O
O
O
O
O
O
O
e.
Meat, poultry, fish & seafood
O
O
O
O
O
O
O
f.
Deli/ready to eat foods
O
O
O
O
O
O
O
g.
Beer/wine
O
O
O
O
O
O
O
h.
Coffee/tea
O
O
O
O
O
O
O
i.
Bread & bakery
O
O
O
O
O
O
O
j.
Bulk products
O
O
O
O
O
O
O
10. Do you have any comments regarding how your primary grocery store meeting your needs with respect to
the products offered/not offered? [Optional—Data will be evaluated at additional cost to co-op]
11. If you are a <name of co-op> member-owner, how important are these features for shopping at <name of coop>? (If you are not a member-owner, please skip to question # 14.)
Very
Important
Important
Somewhat
Important
Not
Important
No Opinion
a. Member-ownership of the
business
O
O
O
O
O
b. Member-owner promotions
O
O
O
O
O
c. Patronage refund
d. Member-owner appreciation
days
e. Ability to vote for board of
directors
f. Other (please specify):
_________________________
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
Copyright 2008 by National Cooperative Grocers Association.
12. Please indicate your level of agreement with the following statements:
a. I know how to contact the co-op
organizing group
b. The organizing group is
responsive to my input
c. I trust the group to use members’
investments appropriately
d. The organizing group is making
timely progress
e. The organizing group has asked
me to volunteer my assistance
f. Other (please specify):
_________________________
Agree
Somewhat
Agree
Somewhat
Disagree
Disagree
No Opinion
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
13. Is there anything else you want to say about <name of co-op>? [Optional—Data will be evaluated at
additional cost to co-op]
Copyright 2008 by National Cooperative Grocers Association.
Personal Characteristics
Please tell us a little about yourself by answering the following questions.
14. Please indicate your level of agreement with the following statements:
Agree
Somewhat
Agree
Somewhat
Disagree
Disagree
a. I exercise on a regular basis.
O
O
O
O
b. Nutritional value is more important to me than price
when buying food.
O
O
O
O
c. Organic foods are very important to me and my family.
O
O
O
O
d. I am proactive about my health.
O
O
O
O
e. I buy local foods when available.
O
O
O
O
f.
I shop in places where I feel a sense of community.
O
O
O
O
g. As much as possible, I shop at locally owned retailers.
O
O
O
O
h. I am willing to pay a little more for products that are
produced more sustainably/with less environmental
impact.
O
O
O
O
i.
O
O
O
O
I engage in activities that address political/social issues.
15. What is your gender?
Male
Female
O
O
16. What is your ZIP code? _________________________
17. 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
18. 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 ____________
19. Are you a member-owner of <name of co-op>?
Not a member
Am a member
O
O
Copyright 2008 by National Cooperative Grocers Association.
20. Including you, how many of the following live in your household?
None
1
2
3+
a. Adults (18+ years old)
O
O
O
O
b. Children
O
O
O
O
21. 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
22. 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
23. 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
24. 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
25. 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
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Copyright 2008 by National Cooperative Grocers Association.
26. 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
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
a. Local postings (signs, bulletin board,
flyers, pamphlets, etc.)
b. Co-op website (including blog)
c. Informal conversations (with co-op
board or staff)
d. Formal meetings (annual mtg, Board
of Director meetings/listening sessions)
e. Emails
f. Mailings (co-op newsletter, annual
g.
report, special mailings)
Other (please specify):
____________________
27. How important to you are the following types of information?
Very
Important
Important
Somewhat
Important
Not
Important
No
Opinion
a. Board of directors news
O
O
O
O
O
b. Community events (e.g. festivals,
O
O
O
O
O
d. Financial information/reports
O
O
O
O
O
e. Other (please specify): _______________
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
j. Locally produced products
O
O
O
O
O
k. Food preparation & recipes
O
O
O
O
O
l. Food safety
O
O
O
O
O
m. Other (please specify): ________________
O
O
O
O
O
n. Fair trade
O
O
O
O
O
o. Producer profiles
O
O
O
O
O
p. Livestock treatment
O
O
O
O
O
q. The environment
O
O
O
O
O
r. Other (please specify): ________________
O
O
O
O
O
Co-op news and information:
celebrations)
c. Co-op progress reports
Information about foods and products:
h. Health and nutrition information
i. Food production practices (e.g. genetically
modified organisms; organics/organic standards)
Social and agricultural issues:
Copyright 2008 by National Cooperative Grocers Association.
28. How satisfied are you with <name of co-op>’s current delivery of this information to you? (optional)
Very
Satisfied
Satisfied
Somewhat
Satisfied
Somewhat
Dissatisfied
Dissatisfied
Very
Dissatisfied
No
Opinion
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
h. Locally produced
products
O
O
O
O
O
O
O
i.
Food prep & recipes
O
O
O
O
O
O
O
j.
Food safety
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
O
m. Producer profiles
O
O
O
O
O
O
O
n. Livestock treatment
O
O
O
O
O
O
O
o. The environment
O
O
O
O
O
O
O
p. Other (please specify):
_________________
O
O
O
O
O
O
O
Co-op news & info:
a. Board of directors
news
b. Community events
(e.g. festivals,
celebrations)
c. Co-op progress
reports
d. Financial
info/reports
e. Other (please specify):
_________________
Information about foods
and products:
f.
Health/nutrition info
g. Food production
practices (e.g.
genetically modified
organisms; organics/
organic standards)
k. Other (please specify):
_________________
Social and agricultural
issues:
l.
Fair trade
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.