Childhood Memory Survey - 问卷调查调研模板

Q1:Your gender is

Male

Female

Q2:Your age is

15

16

17

18

19

Q3:Who mainly take care of you when you are young

Parents

Grandparents

Relatives

Others

Q4:Where did you live when you were young

City

Suburb

Countryside

Q5:How many things do you still remember about your childhood

All of them

A part of

Nothing

Q6:Choose a color to describe your childhood

White

Green

Blue

Pink

Orange

others

Q7:Which represents your childhood

Video Games

Cartoon

Toys

Snacks and beverage

Studying tool

Music and Movies

Q8:Do you still reserve those things you had brought when you were a little

Yes, all of them

Some of them

Not at all

Q9:Does your childhood affect your current life

Yes

No

Q10:Have you made lots of friends in your childhood

Yes

No

Q11:Will you still purchase the products you had used when you are young

Yes

No

Q12:Did your parents pay a lot attention on your education when you are young

A lot

Some

A little

Never

Q13:Have your parents ever taken you to the tutorial school

Instrument

Language

Sports

Arts

Others

I haven't been to those classes

Q14:Have your parents gave you enough pocket money

Yes

No

Q15:How often did your parents give you the pocket money

Everyday

Twice a week

Once a week

Once a month

Never

Q16:How many places have you been to for traveling with your parents

1-5

5-10

10-15

more than 15

Q17:How will you mark your childhood (From one to ten)

1

2

3

4

5

6

7

8

9

10

Q18:Do you want to go back to your childhood

Yes

No