Autos

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* 1. Please fill out the following information so that we can contact you if you pre-qualify for this study.

First & Last Name:

City/State:

Email address:

Phone Number:

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* 2. What is the make, model, and year of the vehicle you drive PRIMARILY?

MAKE:

MODEL:

YEAR:

N/A; I do not have a vehicle

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* 3. Did you purchase or lease this vehicle new or was it pre-owned?

New

Pre-owned

N/A; I do not have a vehicle.

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* 4. How involved were you in the decision to buy this vehicle?

NOT at all involved

NOT very involved

Somewhat involved

Very involved

Extremely involved

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* 5. When do you think you would be ready to buy your next vehicle?

Within the next year

In 2-3 years

In 4-5 Years

Some times after 6+ years

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* 6. What type of engine does your vehicle have?

Diesel Engine

Gasoline Engine

Hybrid Electric Vehicle (HEV)

Plug-in Hybrid Electric Vehicle (PHEV)

Batter Electric Vehicle

I don't know

Other (please specify)

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* 7. Which of the following best describes your ethnic background?

White/Caucasian

Black/African American

Hispanic/Latino

Asian/Pacifc Islander

Other (please specify)

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* 8. What is your current age?

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* 9. Which of the following best describes your marital status?

Married

Live with Partner

Single never married

Divorced

Widowed

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* 10. What is your approximate average household income?

$0-$24,999

$25,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$124,999

$125,000-$149,999

$150,000-$174,999

$175,000-$199,999

$200,000 and up