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Submitted By sampannak
Words 9093
Pages 37
LANDWIRT BRANDED– DELHI –FEB’12

PROJECT LANDWIRT
Card 1 (8-10)
Recruitment Questionnaire
1

0

D

5

D

1

M

0

2

DATE
M
Y
2

5

3

Y
0

1

Y
1

QRE SR.NO.

Y
1

N

ZONE CODE
E W S C

(21)

2

0

MB WEEK NO.
1
1

(22-27)

(11-18)

Area/St Add No.

(31-36)

Int/HH Srl No.

(41-46)

Name of the Respondent
Address

Land mark
Telephone Number

Res:

Work Place:

INTERVIEW START TIME (HHMM)

Mobile
INTERVIEW END TIME (HHMM)

(51-58)

(61-68)

LENGTH OF INTERVIEW
Mins

Random
Booster / Purposive

(71-73)

1
2

(74)
CARD 2 (8-10)

Name of Interviewer

Intr. Code

Name of Team Leader

T L Code

(11-20)
(21-30)

ACCOMPANIMENTS
REF Number

Delhi

02

(42-48)

Chennai

03

Kolkata

04

Coimbatore

05
06

Hyderabad

07

Salem

08

3

FM

(31-41)

2

OFE

01

1

EIC

Mumbai

Bangalore

TL

Centre Name

4

Signature

(49-50)

BACK CHECKED
Tel

Per

REF Number

TL

1

5

(53-63)

EIC

2

6

(64-74)

OFE

3

7

FM

4

8

Signature

CARD 3
QUOTA CHECKING SHEET
SCRUTINISED

AGE

SEC

REF Number

1

25-35

1

SEC B

2

36-45

2

SEC C

TL

SEC A

3

1
(11-21)

EIC

2

(OFE

3

FM

4

(22-32)

(35)

(37)

Signature
Response Translations done by
Name

Ref No. of Tanslator

(41-50)

Response Translations checked by Name

Ref No. of person checking
Translation
(51-60)

1

LANDWIRT BRANDED– DELHI –FEB’12

If this is the first qr (Srl no. 1)used in a st add allotted, write below the exact st add allotted
Allotted St add: ____________________________________________________________this enables to have a control on intrs starting from the given st add in random st add ATPs)

SPEAK TO HOUSEWIFE AGED BETWEEN 25-45 YEARS:
Namaste. I am from Millward Brown. We are one of the largest and most respectful market research organisations.
We conduct research studies in various product fields. We are currently doing a study on certain household products.
Could you spare some time to answer a few

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