Question Title * 1. This survey is being conducted by Adler Weiner Research in order to determine your eligibility for a focus group or interview about which you have been contacted. At no point are your individual answers ever sold or shared with our clients (aggregate data or anonymized summaries of the overall survey information may possibly be shared with our clients, however). This survey serves solely as a means for screening. Once the project has been completed this data will be deleted. For more information please see:Right to Opt-Out InfoFinancial Incentive InfoAdler Weiner Privacy Policy I consent to Adler Weiner Research collecting, storing and processing my personal information for the purpose of determining my eligibility for this market research focus group or interview. I understand and consent to the following: That should I be eligible for participation in this market research focus group or interview, my contact information (phone, email, and home address) may be shared with the client for purposes related only to this particular project and are not limited to: screening calls to further determine eligibility, sending of "homework" or pre-session assignments via email, allowing access to an online platform via email, or for in-home interviews conducted at your residence. Question Title * 2. CONTACT INFO Please provide the following: Name * Address * Apt # if applicable City/Town * State/Province * ZIP/Postal Code * Email Address * Phone Number * Question Title * 3. Which gender identity do you most identify with? Man Woman Nonbinary Other (please specify) Question Title * 4. Which age range do you fall into? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 5. Please state your exact age and date of birth: Age DOB Question Title * 6. Where in the country do you live? Southern CA Northern CA West outside of CA Illinois Midwest outside of Illinois South East Northeast Question Title * 7. We are interested in talking to people with a variety of backgrounds. Have you, or have any members of your family, worked (either currently or at some point) in any of the following types of companies? Marketing Research Advertising, Marketing or Public Relations Firm Media (i.e. TV, radio, entertainment industry, newspaper) Telecommunications or Telephone Company A cable or satellite television provider None of the above Question Title * 8. For classification purposes only, please tell me which of the following best describes your ethnic background? Black, African American, or Caribbean American Asian American or Pacific Islander White or Caucasian Hispanic or Latino/a/x/e Middle Eastern or North African Indigenous or Native American or Alaskan Native Other (please specify) Question Title * 9. What language do you primarily speak at home Question Title * 10. Sometimes we need to speak with people who have and who haven’t been in market research studies in the past. When, if ever, was the last time you participated in an online focus group study? Never Within the last 3 months More than three months ago Question Title * 11. Which of the following describes your household makeup? I am married or living with partner with no kids living at home I am married or living with partner with kids under 18 years old who live with me I am married or living with partner with kids over 18 years old who live with me I am married or living with partner with kids over 18 years old who don’t live with me I am single and live alone I am single and live with a roommate / parents I am single and live with kids under 18 years old I am single and live with kids over 18 years old Other (please specify) Question Title * 12. What is the highest level of education you have completed? Some high school High school graduate 1-3 years of college College graduate Some graduate school Graduate school Question Title * 13. Which of the following best describes your current employment status? I am employed full-time I am employed part-time I am a homemaker I am a full-time student I am retired I am not currently employed Question Title * 14. Which of the following best describes your household income? Under $30,000 $30,000 - $49,999 $50,000-$74,999 $75,000-$99,999 $100,000-$149,999 $150,000+ Question Title * 15. Which of the following paid TV services, if any, does your household receive Cable (e.g. FX, CNN, USA, Showtime etc.) Satellite or Telco/Fiber Online subscription service that streams live TV (e.g., YouTube TV, Hulu + Live TV, Sling TV, etc.) Video streaming service (e.g., Netflix, Disney+, Max, Paramount+, etc.) None of the above Next
