Are you female or male?

[  ] Male

[  ] Female

How old are you?

[  ] 0-17 years

[  ] 18-25 years

[  ] 26-35 years

[  ] 36-45 years

[  ] 46-55 years

[  ] older than 55 years

Which type of media do you use continuous?

[  ] TV

[  ] Radio

[  ] Internet

[  ] Newspaper

Do the media has influence over you?

[  ] Yes

[  ] No

Television:

How many TV’s do you have at your home?

[  ] 1-2

[  ] 3-4

[  ] 5-6

[  ] 7 or more

How often do you watch TV?

[  ] never

[  ] sparse

[  ] often

[  ] very often

Which type of broadcasts do you watch constantly?

[  ] Talkshows

[  ] news

[  ] feature film

[  ] soap

[  ] comedy-series

[  ] other series

Radio:

How often do you listen to the radio?

[  ] 1-2 hours

[  ] 3-4 hours

[  ] 5 hours or more

What do you usually listen to?

[ ] music

[ ] news

[ ] other things

In which situation do you listen to the radio?

[  ] in the car

[  ] at home

[  ] during the work

Do you work on something else when you listen to the radio?

[  ] Yes

[  ] No

Which radio show do you listen to most frequently?

[  ] N-Joy

[  ] FFN

[  ] Hitradio Antenne

[  ] NDR1 / NDR2

[  ] others

Internet:

Do you have internet?

[  ] Yes

[  ] No

How often do you “surf the web”?

[  ] more than 5 hours of a day

[  ] 3-4 hours of a day

[  ] 1-2 hours of a day

[  ] 2-3 times per week

[  ] fewer than 3 times per week

Wherefore do you use the internet?

[  ] fun

[  ] information

[  ] communication

[  ] schoolwork

Which of the following services do you use? Of course, you can tick more than one.

[ ] ICQ

[ ] MSN

[ ] Facebook

[ ] Myspace

[ ] YouTube

[ ] Twitter

[ ] flickr

[ ] IRC-Gallerie

[ ] schuelerVZ/ studiVZ

[ ] others

Newspaper:

Do you read the newspaper?

[  ] Yes

[  ] No

If yes, how often do you read it?

[  ] rarely

[  ] often

[  ] very often

Which part of the newspaper do you prefer?

[  ] sport

[  ] local area

[  ] politics and economy

[  ] weather

[  ] chit-chat

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