TV Viewing - At home Survey

We are currently coducting in-home interviews in your area. We are offering $200 to households who agree to meet with one of our interviewers and a videographer for about 1 hour and a half to discuss the usage of TV content and technology in their household. This meeting would happen on a day and time that is convenient for you and your family between Thursday, November 17th and Sunday, November 20th. Please fill out the following. If you meet the criteria you will receive a follow up phone call to schedule an appointment.

Question Title

* 1. For classification purposes only, what ethnic group or race do you consider yourself a part of?

African-American/Black (non-Hispanic)

Asian

Caucasian/White (non-Hispanic)

Hispanic/Latino

Native American

Other (specify

Question Title

* 2. What is your gender?

Male

Female

Question Title

* 3. Which of the following best describes your age range?

Under 21

21-34 years old

35-55 years old

56 years and older

Question Title

* 4. Often, people who work in businesses related to the products and services we research can bring new insight to our work. Do you or any member of your household or family CURRENTLY WORK in…?

A market research company

In marketing, advertising, or public relations

A cable TV or telecommunications company

In food service/hospitality

In banking or finance

In radio/TV/film/journalism/media

Or are you personally a full-time student

None of these

Question Title

* 5. Which of the following best describes your household?

You are married or living with a partner and have children under 18 living at home

You are married or living with a partner and do not have children under 18 living at home

You are not married or living with a partner, but have other people living in your home such as roommates, other family members, etc.

You live alone

Question Title

* 6. If you have kids. How many are under 18yrs old, living at home?

1-2

2 or more

0, I don't have any kids

Question Title

* 7. Which of the following services, if any, do you or anyone in your household have at home?

Cable television service

Satellite television service

TV service provided by a telephone company like Verizon FiOS TV or AT&T U-verse TV

Internet service

High speed Internet service

Landline telephone service at home

Cell phone service

NONE OF THESE