Survey Your Name (required) Your Email (required) Resident Country Are You: A first time visitor A repeat visitor Where did you find us Q Pages Hardcopy Advertising Another Website A Friend What is your Age Under 16 16-18 19-21 22-25 26-29 30-34 35-39 40-49 50-59 60+ What is your Sexual Orientation Gay Lesbian Homosexual Queer Bisexual Heterosexual Transgendered Unsure Do you consider yourself to be OUT Out at work: Yes NoOut with friends: Yes NoOut with family: Yes No With Family In the next election who would you most likely vote for (Australian Residents Only) Labour Liberal National Democrat Green One Nation Independent Unsure Type of Residence Own Your Home Paying Off Your Home Renting - alone Renting - shared Living with Family Other Education Year 10 High School Year 12 High School Apprenticeship Tafe/Technical College University/College Degree Post Graduate Qualification Employment Self Employed Employed Full time Employed Part time Student Seeking Work No Longer Working What is your yearly income AU$10,000 or Less AU$10,000 - AU$20,000 AU$20,000 - AU$25,000 AU$25,000 - AU$30,000 AU$30,000 - AU$35,000 AU$35,000 - AU$40,000 AU$40,000 - AU$45,000 AU$45,000 - AU$50,000 AU$50,000 - AU$65,000 AU$65,000 - AU$80,000 AU$80,000 - AU$100,000 AU$100,000+ Relationship Single and happy to stay so Single - looking for same gender partner Single - looking for different gender partner Homosexually committed/married Heterosexually committed/married Other Length of Relationship None Less than one month 1-6 months 6 months - 1 year 1-2 years 3-5 years 6-10 years More than 10 years If longer than 10 years - how long Household size One Two Three Four Five or more Do you live with your lover Yes No How often do you use Q Pages Always Often Occasionally Seldom Never Do you tell advertisers that you saw them in Q Pages or on the Q Pages Website Yes No Sometimes Have you purchased items through the internet Yes No How often do you Dine out per week None One Two Three Four Five or more How many times do you go to gay/lesbian clubs per month None One Two Three Four Five or more Total Vacation time in the last 12 months None One Week Two Weeks Three Weeks Four Weeks Five Weeks or more Type of Vacation Stayed at Home Visited own country Went Overseas Took a Cruise Other Do you have a Website Yes No What is your opinion of our website Fantastic Terrible Easy to Use Found good information Didn't find information Will you use our site in the future Yes No Not Sure What would you like added to the site General Comments Would you like to receive further information Yes No Enter captcha code To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.
