Welcome to Verified's sample Readership Survey. This survey is designed to help publishers gather inportant demographic information about their readers, their preferences and purchasing plans. The Readership Survey is highly customizable and can be adapted to any scale across various media channels. What follows is an example of a brief opening statement and 14 survey questions. Graphics and other branding tools can easily be added to the survey along with additional questions. We wlecome your feedback.

This survey is being conducted by Verified Audit Circulation on behalf of this publication.

Please be assured that Verified will protect your confidentiality. The answers you provide are for research purposes only, and they will only be used in combination with all other responses.

Any contact information you provide will be protected. You will not be asked to buy anything today, or in the future, as a result of taking this survey.