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Mobile Phone Survey
Consent to Participate
I am 16 years of age or older.
I agree to participate in this research.
This agreement is of my own free will.
I understand that I may refuse to provide answer to any questions and my end my participation at any time.
I have been given full information about this survey and the contact information for the researchers.
About You
Age:
-- select one --
Under 16
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100
Gender:
Male
Female
Occupation:
Living Status:
Please Tick All That Apply
Alone
With Partner
With Parents
With Children
With Flatmates
Other:
In which city/town/village do you currently live?
Which languages do you speak fluently?
Your Mobile Phone
What kind of mobile phone do you have?
Make:
Model:
How long have you had this mobile phone?
Years:
Months:
Which mobile devices do you usually carry with you?
Mobile Phone
Additional Mobile Phone
PDA
MP3 Player
Radio
GPS Device (not on mobile phone)
Camera/Video Camera (not on mobile phone)
Other:
What kind of mobile phone service do you have?
Pay-as-you-go Connection (with Data)
Pay-as-you-go Connection (without Data)
Pay Monthly Connection (with Data)
Pay Monthly Connection (without Data)
What allowances does your service include?
How many of the following items do you do per day?
Texts:
Picture Messages:
Phone Calls: