Surveyonics - Online Survey Software

Estimating Cost of Living
For your convenience and ease of reference, we have created a template of Cost of Living Survey. You can use this template as such or modify it to suit your needs. Alternatively, you can design your own survey from scratch.

 Question: How much do you spend per month on groceries?
Less than 200
$200 - $250
$250 - $300
$300 - $350
$350 - $400
$400 - $450
$450 - $500
More than $500
 Question: How much do you contribute per month toward your retirement plan(s) and social security?
 Question: In which age-group do you fall?
16 - 19
20 - 29
30 - 39
40 - 49
50 - 59
60 - 69
70 and above.
 Question: What is the average monthly rent you pay for housing/accommodation?
$500 - $1000
$1100 - $1500
$1600 - $2000
$2100 - $2500
$2600 - $3000
$3100 - $3500

Other
 Question: How much do you spend per month on transportation which includes gasoline, maintenance, repairs and auto insurance?
Less than $200
$200 - $250
$250 - $300
$300 - $350
$350 - $400
$400 - $500
More than $500
 Question: In what type of an accommodation do you currently live?
One bedroom accommodation
Two bedroom accommodation
Three bedroom accommodation
Four bedroom accommodation
Five bedroom accommodation

Other
 Question: Please specify your gender.
Male
Female
 Question: Please mention the name of your city and state.
 Question: What is the health insurance premium you pay for a single person per month?
Less than $100
$100 - $150
$150 - $200
$200 - $250
$250 - $300
$300 - $350
$350 - $400
$400 - $450
$450 - $500
More than $500
 Question: What is the average monthly cost you pay for utilities such as gas,electricity,water,cable and internet?
Less than $100
$100 - $150
$150 - $200
$200 - $250
$250 - $300
$300 - $350
$350 - $400
$400 - $500
More than $500
 Question: In what industry do you work?
Manufacturing
Leisure and Hospitality
Education
Healthcare
Financial/Professional
Social Service
Government
Trade
Technology
Agriculture
Real Estate/Construction
Transportation

Other