Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 5Name of FieldworkerFirstLastProvinceEastern CapeFree StateGautengKwaZulu-NatalLimpopoMpumalangaNorthern CapeNorth WestWestern CapeDistrictNearest TownNextA1. Age18 - 2425 -2930 - 3435 - 3940 - 4950 - 6565+Which age group do you fall inA2. GenderFemaleMaleLGBT+Are youA3. RaceBlackColouredIndianWhiteRace by observationA4. Marital StatusMarriedDivorcedSeparatedSingleWidowedAre youA5. Highest Education qualificationPrimary SchoolHigh schoolCollegeDegreePost Graduate degreeNever went to schoolWhat is the highest education level that you have attainedA6. Employment StatusEmployed – Full timeEmployed – Part timeUnemployed- Looking for work.Self-employed.PensionerGrant recipientCollege StudentUniversity StudentUnemployed – Not looking for work.What is your current occupation or work that you do?A7. Where do you liveTownshipVillageFarmSuburbHostelArea of residenceA8. Describe your resident typeHome OwnerRented a houseRented a flatRented a back roomShackAre YouA9. What is your monthly incomeBelow R2499R2500 - R4999R5000 – R9999R10 000 – 14999R15000- 19999R20000 +Refused to answerA10. If unemployed, which of the following is your source of income?Supported by family.SASSAA11. Roughly How much financial support do you receive a monthBelow R999R1000 – R4999R5000 – R9990R10000+Refused to answerA12. Do you receive it weekly or monthlyWeeklyMonthlyA13. In total how much is your household income including yoursbelow R2499R2500 - R4999R5000 – R9999R10000 – R14999R15000- R19999R20000 +Refused answerA14. Do you have access to the internetYesNoA15. Does your household have access to the followingTVRadioComputerDSTVA16. Does your household have access to electricityYesNOA17. Does your household have access to waterYesNoNextB1. Name your preferred betting outlet/siteB2 How often do you gamble?DailyWeeklyMonthlyB3. How were you introduced to sports bettingFriendsFamilyColleagueSaw a sports betting advertisementB4. If you selected option 4 in C3, state Where you saw the adsocial mediaTVFamily, relatives & colleaguesB5. How do you mostly place bets?OnlineOver the counterBoth online and over the counterB6. If you selected online, which device do you useMobile phoneTabletLaptopDesktopB7. State reasons for your preferred optionIt is close to my homeIt is easily accessibleIt is affordableB8. How much time do you devote to a single betLess than an hour1 hour – 2 hours3 hour – 4 hoursMore than 5 hoursB9. How often do you win from gambling?AlwaysOnce a weekNeverOnce a monthB10. How long have you been participating in sports bettingLess than a year2 – 3 years4 – 5 YearsMore than five yearsB11. What do you do before placing a betAsk a friend for adviceCheck on the internet for best oddsAsk best odds on social media groupsB12. Do your family or friends approve your gambling behaviourYesNoThey don’t knowB13. Apart from gambling, what other activities do you do whilst you at a gambling site?Drink alcoholDrink non-alcoholicEatWatch sports.DanceB14. Is there someone in your family who is gamblerYesNoB15. If Answered Yes who in your family gambles?SiblingParentClose relativeB16. Why do you participate in sports betting activitiesFor pleasureTo de-stressTo earn extra incomeI cannot help itFor entertainmentB17. On average, how much do you spend on bettingBelow R50R100 - R200R201 – R300R301- R400R401- R500R501 +B18. What is the highest amount that you have ever lost in gambling?Below R999R1000-2499R2500 – 4999R5000- R9999R10000- 14999R15000- 19 999R20000 +B19. How much time do you devote to a single gambling activityLess than an hour1 hour1-2 hours2-3 hours3-4 hours4-5 hoursMore than 5 hoursB20. How often do you win from gambling?NeverAlwaysEverydayOnce a weekOnce a monthNextC1. Over the past 6 months, have you bet more than you could afford to lose?NeverSometimesMost of the timeAlmost AlwaysC2. Have you ever gambled with larger amounts of money even though you could not affordNeverSometimesMost of the timeAlmost AlwaysC3. When you lost, do you go back to attempt to win back the money you lost?NeverSometimesMost of the timeAlmost AlwaysC4. Have you borrowed money anything to get money to gamble?NeverSometimesMost of the timeAlmost AlwaysC5. Have you sold anything to get money to gamble?NeverSometimesMost of the timeAlmost AlwaysC6. Have you felt that you might have a problem with gambling?NeverSometimesMost of the timeAlmost AlwaysC7. Has gambling caused you any health problems, such as stress or anxiety?NeverSometimesMost of the timeAlmost AlwaysC8. Have you been criticised or told that your gambling is out of control, regardless of whether or not you thought it was true?NeverSometimesMost of the timeAlmost AlwaysC9. Has gambling resulted to any financial problems?NeverSometimesMost of the timeAlmost AlwaysC10. Has your gambling impacted on your social life?NeverSometimesMost of the timeAlmost AlwaysNextSubmit