Screener Survey

OMB No. 1625-0089
Expiration Date: / /

National Recreational Boating Survey
Screener Questionnaire
(For States Providing Boat Registration Data)
Hello. My name is ____________________.
I am calling to invite you to participate in a survey that is being conducted by [contractor name] for
the U.S. Coast Guard. The purpose of this survey is to identify boating households that will
eventually be solicited for participation in the National Recreational Boating Survey. The National
Boating Survey aims at finding out about people’s recreational boating experiences to improve
the effectiveness of boating safety programs. Your telephone number has been randomly
selected as part of this study.
1.

Are you a person 16 years of age or older who resides in a U.S. household?
 YES
→ (skip to question #3)
 NO
 REFUSED
→ (End screener)
 ANSWERING MACHINE → (Leave a message, and call back)
 NONWORKING, DISCONNECTED, CHANGED
→ (End screener)

2.

May I speak to a household member who is at least 16 years old?




YES → (skip to question #2)
NO ONE LIVING IN HH IS 16 OR OLDER → (end screener)
NOT AVAILABLE → (end screener)

3. What is the primary use of this phone number?




HOME USE
HOME AND BUSINESS USE
BUSINESS USE ONLY→ (end screener)

4. How many working home-use telephone numbers do you have? ____
5. Did anyone in this household participate in any recreational boating activity during the
year 2007:
 YES
 NO
→ (skip to question #9)

U.S.C.G. Screener Survey for States Providing Registration Data
FORM NRBS–1SCR2007
10/3/2007

6. Starting with yourself, what is the age and first name of everyone living in your
household?
Persons

Gender

Age

Boated in
2007?

Boated prior
to 2007?

Yourself

 Male

 Female

______





Person 2

 Male

 Female

______





Person 3

 Male

 Female

______





Person 4

 Male

 Female

______





Person 5

 Male

 Female

______





Person 6

 Male

 Female

______





Person 7

 Male

 Female

______





Person 8

 Male

 Female

______





Person 9

 Male

 Female

______





7. Does any one in this household own a REGISTERED recreational vessel?



Yes
No

8. What language do the adults in this household speak most of the time they are at home?

9.



ENGLISH



SPANISH



JAPANESE



CHINESE



VIETNAMESE



KOREAN



FILIPINO



OTHER _______________

What county do you live in?

County name: _______________

10. What is your zip code?

11. May I have your household’s Mailing Address?
STREET:

____________________________________

CITY:

____________________________________

ZIP:

____________________________________

U.S.C.G. Screener Survey for States Providing Registration Data
FORM NRBS – 1SCR2007
10/3/2007

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