595 In Home Opinion Study

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* 1. Contact Info

Name

Phone

E-Mail

Gender

Age

City, State

Zip Code

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* 2. Can you confirm that you agree to have no more than MAX ONE person at home at the time of the study?

Yes

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* 3. Are you the sole owner/legal tenant of this home?

Yes

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* 4. If no, do you have the permission of the co-owner / partner of your hime to take part in this research study?

Yes

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* 5. Do you work for any of the following companies?

A. SAMSUNG

B. APPLE

C. GOOGLE

D. MICROSOFT

E. DELL

F. HP

G. ACER

H. LENOVO

I. SONY

J. AMAZON

K. IBM

L. FACEBOOK

M. HUAWEI

N XIAMOI

O. OPPO

P. ASUS

Q. HTC

R. FOXCONN

S. None of the above

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* 6. Are you a US Citizen?

Yes

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* 7. Do you have at least 4 rooms in which we will be allowed to collect data? During which time you would not be able to enter into these rooms. Please confirm this will be possible.

Yes

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* 8. Do you live in a

Apartment

Townhouse

Single Family House

Multi Family House

Other (please specify)