Note: This is just an example of the actual survey used in this study.

Open Access Publishing Article Processing Charge (APC) Survey

Thank you for providing us with information about your recent publication. Please complete the questions below and press the "Submit" button.

1. Select the source of funding used to cover the article processing fee for your recent publication. If multiple sources of funding were used, list these in the text box below for "other sources" along with the approximate percentage from each source.
  A research/scholarly grant or contract used to fund the research/scholarship on which the article was based.
  Government funding based on an national policy that funds open access publishing fees.
  Institution funding based on an institutional policy that funds open access publishing fees.
  Departmental or other institutional discretionary funds that can be used for funding open access but not specifically designated for that purpose.
  The fee was waived.
  Personal funds
  Other described below:

If other sources of funding were used for the article processing fee, please describe. If multiple sources were used, please list with the approximate percentages.

2. Please rate the influence of each factor below on your choice of the journal in whch to publish your recent article. If there were other  important factors influencing your decision, please list in the text box below.
      Very Important Important Some Influence little Influence No Influence
  a. The quality/impact of the journal
  b. The fact the journal is open access
  c. The fit of your manuscript with the scope of the journal
  d. Speed of review/publication process
  e. Likelihood of manuscript being accepted
  f. Type of readership

Please describe any other factors that had a signifiant influence on your choice of the journal.

3. If there were a journal in which you had a strong desire to publish, what would be the maximum APC you would be willing to Pay? Please specifiy a numeric value in USD. $
4. Approximately how many articles have you published over the last five years (Please enter numeric values):
  a. In subscripton journals.
  b. In open access journals that do not charge a article processing fee.
  c. In open access journals that charge article processing fees.

Check here if you would like a summary of the results of this suvey.

When completed, please press the "Submit" button. Thank you completing the survey.

[Submit]