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. What is your gender? Female Male Other (specify) Question Title * 4. Please select your current age range. Under 18 18-24 25-29 30-34 35-44 45-49 50+ Question Title * 5. For classification purposes only, please tell me which of the following best describes your ethnic background? African-American or Black Asian or Pacific Islander Caucasian or White Hispanic or Latino Native American Indian Multiracial Other (please specify) Question Title * 6. Sometimes we need to speak with people who have and who haven’t been to market research studies in the past. When, if ever, was the last time you participated in a market research study? 0-3 months ago More than 3 months ago Next
