The Consumer Council is very interested in finding out how, if at all, people in Northern Ireland are being affected by the current rises in the cost of living and the wider financial climate.  We would appreciate it if you could spend a few moments completing this questionnaire.  All information you provide will be treated as confidential and will only be used in summary of all those who fill out the questionnaire for us.   Once you have completed the questionnaire please click on the submit button at the end to ensure we receive your response.

Section A - Your concerns

A1. To what extent do you agree or disagree with the following statement... “I am worried about the impact of the cost of living on my ability to make ends meet in my household budget”
	Strongly agree
	Agree
	Neither agree not disagree
	Disagree
	Strongly disagree
	Don't know or prefer not to say

A2. Which, if any, of the following are worrying you because of the rises in cost of living?
	Cost of home heating (eg oil, gas, electricity)
	Cost of petrol / diesel
	The value of my house decreasing
	Repaying credit cards  loans or other personal debt
	Mortgage repayments
	Paying rent
	Food prices
	The threat of losing my job
	Replacing large household items (eg washing machine)
	Not being able to buy clothes or shoes
	Not being able to buy gadgets
	Not being able to go out drinking or socialising
	Cost of Christmas or other big events
	None of these
	Don’t know

Section B - What are you doing or planning to do differently

B1.  Are you cutting back, or are you planning to cut back on any of the following because of the rises in cost of living?
	Food
	Home heating (eg oil, gas, electric)
	Petrol / diesel
	Leisure activities (e.g. cinema  concerts)
	Holidays
	Clothes or shoes
	Gadgets
	Going to the gym
	Hobbies
	Going out socialising
	The amount you spend at Christmas
	Big purchases eg a car, new kitchen, renovations
	None of these
	Don’t know
	Other

B1  Other - please specify

B2.  Have you cut back or made changes to the following financial products in the last year?
	Car insurance
	Life assurance
	Home insurance
	Mortgage
	Savings
	Loans
	None of these

B3.  Are you doing, or are you planning to do any of the following because of the rises in cost of living?
	Shopping around for cheaper prices
	Walking/ cycling rather than use a car
	Cooking/ preparing food at home rather than going out for meals
	Arranging activities that are free or cheaper than normal
	Taking out a loan
	Cutting down on waste
	Setting a budget
	Remortgaging
	Going to an evening or part-time class to get better qualifications
	Turning down your heating
	Looking for a better paid job
	Working more overtime
	Looking for or working in a second job
	None of these
	Don’t know

Section C - About your financial management

C1.  Over the last year how often have you worked out a budget for your household bills and everyday spending?
	Daily
	Weekly
	Monthly
	2 to 4 times a year
	Yearly
	Less often
	Never
	Don't know

C2.  How well are you currently keeping up with bills and credit commitments?
	Keeping up with all bills and commitments without any difficulty
	Keeping up with all bills and commitments but struggle from time to time
	Keeping up with all bills and commitments but it is a constant struggle
	Falling behind with some bills or credit commitments
	Having real financial problems and have fallen behind with commitments

Section D - About you

We want to ensure that we obtain the views of a wide range of consumers.  We would appreciate it if you could answer a few questions about your background.  Please be assured that all responses will be treated as confidential and will not be linked back to you.

D1.  What is your gender?
	Male
	Female

D2.  What is your age?
	Under 18
	18 to 24
	25 to 34
	35 to 44
	45 to 54
	55 to 64
	65 or over

D3.  What is your postcode? (First half only)

D4.  What is the occupation of the main income earner in your household? (If retired please state former occupation)

Thank you for completing our questionnaire - Please click the submit button to ensure we receive your reply