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Consumer Survey Form

Please complete all fields.

Age Range:		Gender:	Zip Code:
Under 18 18 to 25 26 to 35 36 to 45 46 to 65 Over 65		MaleFemale
Household Income:		Adults in Household:	Children in Household:
$0 to $19,000 $20,000 to $34,000 $35,000 to $49,000 $50,000 to $74,000 $75,000 to $124,000 $125,000 to $250,000 Over $250,000		1 2 3 4 5+	1 2 3 4 5 6 7 8 9 10+
1. If you used an e-cycle St. Louis site, which one did you use?
DCAL Services LLC EPC GUNTHER HI-TECH CHARITIES Midwest Computer Recycling MRC - Midwest Recycling Center RECYCLE WORKS CENTRAL RECYCLE WORKS WEST RIMCO (URI) RNA WorldWide, LLC WITS
2. What is most important in choosing a recycling site?
Location  Cost  Service  Other
3. How did you hear about e-cycle St. Louis?
Word of Mouth  Advertisement/News Story  City/Community Newsletters  Internet  Other
4. I recycle because it:
Helps the Environment  Helps the Economy  Protects Public Health  Saves Me Money  Imrpoves Our Children's Futures  Other
5. Please choose the response which best answers each of the following questions:			Strongly Agree Agree Disagree Strongly Disagree N/A
a. It was easy to recycle my electronics...
b. I will tell a friend about my recycling experience...
What suggestions could you make on improving or making the program more effective?

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