Thank you for your interest in participating in Spectra's Product Testing and Review Panel.

Please answer the following survey questions to help us understand how your participation may assist in providing feedback with new product testing or product reviews. Answering these questions as thoroughly and honestly as possible will help us understand the future panel opportunities that best align with your interests and the current stage of your breastfeeding journey.

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* 1. Do you Opt-in to receive email messages regarding eligible product surveys and test programs?

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* 2. Please complete the information below if you are interested in applying to the Spectra Product Panel! Skipped questions may disqualify you from participating on the panel.

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* 3. How did you hear about Spectra's Product Panel?

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* 4. Are you or any of your family members currently or have previously been employed by Spectra Baby USA?

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* 5. Have you or any of your family members been employed by a breast pump company such as Medela, Elvie, or Ameda?

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* 6. How old are you?

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* 7. What is your date of birth?

Date

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* 8. What is your ethnicity?

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* 9. Please indicate your gender.

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* 10. Are you currently breastfeeding?

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* 11. How often do you breast pump?

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* 12. Please enter the links or URLs to your social media platforms.
Example:
Instagram: instagram.com/spectrababyusa/

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* 13. Please share a photo of yourself. (Skip this question if you prefer not to share)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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