SurveyMonkey Powered Online Survey

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 Info
Financial Incentive Info
Adler 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. FOR IN PERSON RESEARCH:
In order to gain admittance to the facility, you need to bring:

A Photo ID

Reading glasses if you need them

Please make sure to self assess your health prior to the session and we ask that you cancel in advance if you are sick with Cold/Flu/Covid-19 symptoms.

Frequently we do not allow cell phones, smart watches, cameras or any electronic/digital devices into the research. There is a possiblity you will be asked to leave your devices with our front desk team where they will be kept securely during the research.

If qualified and based on these participation requirements, are you willing to participate in this in-person interview?

Yes

Question Title

* 3. Please fill in the following

Name

Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 4. With which gender do you identify?

Male

Female

Non-binary

Other (please specify)

Question Title

* 5. With which ethnicity do you most identify?

White

Asian or Asian American

Hispanic or Latino

Black or African American

Native Hawaiian or other Pacific Islander

Native American or Alaska Native

Other (please specify)

Question Title

* 6. To which age group do you belong

Under 18

18-19

20-24

25-29

30-34

35-39

40-45

Over 45

Question Title

* 7. What is your exact age?

Question Title

* 8. Are you or is anyone in your household currently employed by…?

	Yes	No
An advertising, public relations, marketing, media or publishing company or agency	An advertising, public relations, marketing, media or publishing company or agency Yes	An advertising, public relations, marketing, media or publishing company or agency No
A market research company or department	A market research company or department Yes	A market research company or department No
A company involved with the exhibition or distribution of TV shows, movies or video games	A company involved with the exhibition or distribution of TV shows, movies or video games Yes	A company involved with the exhibition or distribution of TV shows, movies or video games No
A company involved with making or manufacturing electronic devices	A company involved with making or manufacturing electronic devices Yes	A company involved with making or manufacturing electronic devices No
A company involved with marketing and distributing packaged food or beverages	A company involved with marketing and distributing packaged food or beverages Yes	A company involved with marketing and distributing packaged food or beverages No
An insurance or financial planning agency	An insurance or financial planning agency Yes	An insurance or financial planning agency No

Question Title

* 9. Which of the following best describes your annual household income?

Under $20,000

At least $20,000 but less than $30,000

At least $30,000 but less than $45,000

At least $45,000 but less than $60,000

At least $60,000 but less than $75,000

At least $75,000 but less than $100,000

At least $100,000 but less than $150,000

At least $150,000 but less than $200,000

At least $200,000 or more

Question Title

* 10. Are you filling this out for you or your 16/17 year old teen?

I am filling this out for me

I am filling this out for my teen