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London Business School Pre-Registration for Online Studies
1. Panel Member Information
This information is being collected for research purposes only. It will be kept strictly confidential.
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1
. Please enter the email address at which you would like to receive payments for the studies you complete. If you have a PayPal account, this should be the email address associated with your PayPal account.
Please enter the email address at which you would like to receive payments for the studies you complete. If you have a PayPal account, this should be the email address associated with your PayPal account.
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. First Name
First Name
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. Last Name
Last Name
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. Address Line 1
Address Line 1
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. Address Line 2
Address Line 2
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. City
City
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. State/Province
State/Province
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. Postal Code
Postal Code
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9
. Country of Residence
United Kingdom
United States
Afghanistan
Albania
Algeria
Andorra
Angola
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahrain
Bangladesh
Belarus
Belgium
Belize
Bolivia
Bosnia and Herzegovina
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Cambodia
Canada
Chile
China
Colombia
Congo, Democratic Republic of
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Guatemala
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Liberia
Lithuania
Luxembourg
Macedonia, The Former Yugoslav Republic of
Madagascar
Malaysia
Maldives
Malta
Mauritania
Mauritius
Mexico
Micronesia, Federated States of
Moldova
Monaco
Mongolia
Morocco
Namibia
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Lucia
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
South Africa
Spain
Sri Lanka
St. Kitts & Nevis
Sudan
Sweden
Switzerland
Taiwan
Thailand
Trinidad and Tobago
Turkey
Turkmenistan
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Western Samoa
Yemen
Yugoslavia (Serbia and Montenegro)
Zimbabwe
Other (please specify)
Country of Residence
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. How many years have you resided in this country?
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100
How many years have you resided in this country?
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. Are you eligible to vote in the country in which you reside?
Are you eligible to vote in the country in which you reside?
Yes
No
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. Home Phone
Home Phone
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. Work Phone
Work Phone
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14
. Gender
Gender
Male
Female
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. Year of Birth
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
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1931
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1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
Year of Birth
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. Month of Birth
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Month of Birth
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. Day of Birth
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Day of Birth
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18
. Language in which you are most fluent:
English
Arabic
Armenian
Bengali
Portuguese (Brazilian)
Bulgarian
Chinese
Czech
Dutch
Finnish
Flemish
French
German
Gujariti
Greek
Hebrew
Hindi
Hungarian
Icelandic
Italian
Japanese
Javanese
Korean
Malay
Persian
Polish
Portuguese (European)
Romanian
Russian
Serbo-Croatian
Slovene
Slovak
Spanish
Swedish
Tagalog
Telugu
Tamil
Thai
Turkish
Ukrainian
Urdu
Vietnamese
Other (please specify)
Language in which you are most fluent:
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19
. After the age of 16, how many years have you spent studying for degrees? For example, if you went to school continuously to age 18, then worked 3 years, then went to university and received a degree in 4 years, you would enter "6" (2 years directly after age 16, plus 4 years of university).
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After the age of 16, how many years have you spent studying for degrees? For example, if you went to school continuously to age 18, then worked 3 years, then went to university and received a degree in 4 years, you would enter "6" (2 years directly after age 16, plus 4 years of university).
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. How many packs of cigarettes do you smoke per week?
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How many packs of cigarettes do you smoke per week?
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. How many cups of caffeinated beverages (coffee, tea, etc.) do you drink per day?
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How many cups of caffeinated beverages (coffee, tea, etc.) do you drink per day?
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22
. How many alcoholic beverages do you consume per week?
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70
How many alcoholic beverages do you consume per week?
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23
. What is your marital status?
Single, never married
Single, divorced
Single, living with partner
Single, widowed
Married
What is your marital status?
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24
. How many children do you have?
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How many children do you have?
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25
. Are you employed full time?
Are you employed full time?
Yes
No
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26
. What is your annual income in US Dollars? (A currency converter can be found
here
).
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10000
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775000
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825000
850000
875000
900000
925000
950000
975000
1000000
What is your annual income in US Dollars? (A currency converter can be found
here
).
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