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Created by STATKON, 20 Chiselhurst, APK, UJ

statkon@uj.ac.za TEL: 27 11 559 2851 FAX: 27 11 726 8978

Example of a questionnaire: coffee consumption1
COVER LETTER The first page of a questionnaire is usually devoted to the cover letter. The cover letter is the researcher’s last chance to elicit participation in the research. The cover letter should tell the respondent: • Why the research is being undertaken • Who is doing the research • Why is it important to respond • How long it will take to complete the questionnaire • How and when the questionnaire should be returned • What the contact details of the researcher is • Whether his/her responses will be treated confidentially, i.e. ensure the respondent of anonymity.

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Use each of the numbers 1 to 6 only once. Reasons for not consuming coffee in last 6 months Rank I do not like the taste of coffee I do not like the smell of coffee Coffee is expensive I do not drink coffee for health reasons I cannot sleep when drinking coffee I prefer drinking tea

Thank you for your co-operation in completing this questionnaire. Kindly return the questionnaire as specified in the cover letter.

The following questions only pertain to people who have consumed coffee in the last six months. 10. In a typical day, how many cups of coffee do you drink? 2 cups or less 1 3-4 cups 2 5-6 cups 3 7-8 cups 4 9 cups or more 5

11. How often do you drink coffee on each of the following occasions? Never Rarely First thing after waking up in the morning? 1 2 With breakfast? 1 2 During your morning break? 1 2 With lunch? 1 2 During your afternoon break? 1 2 With dinner? 1 2 In the evening after dinner? 1 2 At bedtime? 1 2 When going out for a meal at a restaurant? 1 2 When visiting friends or family? 1 2 When you are stressed? 1 2

Often 3 3 3 3 3 3 3 3 3 3 3

Always 4 4 4 4 4 4 4 4 4 4 4

Created by STATKON, 20 Chiselhurst, APK, UJ

statkon@uj.ac.za TEL: 27 11 559 2851 FAX: 27 11 726 8978

12. Please indicate which one of the following types of coffee you use most and which one you prefer most. (Mark one option only in each of the columns.) Used most Preferred Instant (e.g..

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