Anti-Aging Games, LLC Beta-Tester Sign-up Survey

Anti-Aging Games, LLC Beta-Tester Sign-up

Hello. Thank you for participating in this important research survey from Anti-Aging Games, LLC. Your feedback is greatly appreciated! All results are confidential. Anti-Aging Games are designed to sharpen short-term memory, concentration and focus for people over 35. Sign up now as a beta-tester and you will a VIP pass for 30% off our regular prices and a free month-long trial as soon as we launch!

Please forward this survey to your friends who are 35 and older. The person whose name gets mentioned the most in the referral section will get a $50 amazon gift certificate.

1. How old are you?

How old are you?

2. How many of your biological parents are still alive?

How many of your biological parents are still alive? 0

3. If you have a parent who is still alive, do you worry about him/her getting Alzheimer's, dementia, or age-related cognitive impairments?

If you have a parent who is still alive, do you worry about him/her getting Alzheimer's, dementia, or age-related cognitive impairments? Yes, I worry about that possibility

No, I don't worry about that possibility

My parent already has one of those diseases

My parents are not alive

4. Do you worry about your future chances of getting Alzheimer's, dementia, or age-related cognitive impairments?

Do you worry about your future chances of getting Alzheimer's, dementia, or age-related cognitive impairments? Yes, I worry about that possibility

No, I don't worry about that possibility

I already have one of those diseases

5. Have you experienced forgetfulness due to aging?

Have you experienced forgetfulness due to aging? Yes

6. Would you buy a game (for your PC or Mac) designed to help keep your memory and focus sharp?

Would you buy a game (for your PC or Mac) designed to help keep your memory and focus sharp? Yes

7. What is the maximum amount of time that would you be willing to invest in increasing your mental fitness using such a game? (Assume it's fun enough to keep your attention.)

What is the maximum amount of time that would you be willing to invest in increasing your mental fitness using such a game? (Assume it's fun enough to keep your attention.) 1 hour each time I play

30 minutes each time I play

15 minutes each time I play

8. What is the maximum number of days per week you would be willing to play such a game?

What is the maximum number of days per week you would be willing to play such a game?

9. Would you like to be contacted when the game is developed?

Would you like to be contacted when the game is developed? Yes

10. If you answered yes to Question #9, please enter your email address here. Your privacy is important and your email address will not be sold.

If you answered yes to Question #9, please enter your email address here. Your privacy is important and your email address will not be sold.

11. What is your gender?

What is your gender? Female

Male

12. What is your education level?

What is your education level?

13. Do you currently have a job?

Do you currently have a job? Yes, I have a job

No, I am retired

No, I am a housewife/househusband

No, I am unemployed temporarily

No, I am physically challenged and do not work

No, I am a student

Other (please specify)

14. What state do you live in?

What state do you live in?

15. What is your annual household income? (This information is confidential)

What is your annual household income? (This information is confidential)

16. Would you ever buy this game as a gift? Please check all that apply

Would you ever buy this game as a gift? Please check all that apply Yes, I would buy it as a gift for my parent(s)

Yes, I would buy it as a gift for my spouse

Yes, I would buy it as a gift for someone else other than parent or spouse

17. Would you be interested in a version of the games for your phone?

Would you be interested in a version of the games for your phone? No

Yes, and I have an iPhone

Yes, and I have a Blackberry

Yes, and I have a Palm

Yes, and I have something other than an iPhone, Blackberry, or Palm

18. How did you hear about this survey? (Please list the website or name of the person forwarding it to you.)

How did you hear about this survey? (Please list the website or name of the person forwarding it to you.)

19. If you would like to become a beta-tester when the games are done, please enter your information here. A limited number of VIP beta-tester subscriptions will be available. VIPs get one month free and 30% off the regular price if they choose to keep the membership beyond the free trial. Your information is confidential and will never be sold.

If you would like to become a beta-tester when the games are done, please enter your information here. A limited number of VIP beta-tester subscriptions will be available. VIPs get one month free and 30% off the regular price if they choose to keep the membership beyond the free trial. Your information is confidential and will never be sold. Name:
Email:
Phone number:

20. If you are planning on forwarding this to your friends and would like to be tracked to win the $50 gift certificate for sending the most referrals please enter your name and email below. (But please don't spam strangers- we want to keep this ethical!)

If you are planning on forwarding this to your friends and would like to be tracked to win the $50 gift certificate for sending the most referrals please enter your name and email below. (But please don't spam strangers- we want to keep this ethical!) Name:
Email:

21. If you have any other comments or suggestions, please add them here. Thank you!

If you have any other comments or suggestions, please add them here. Thank you!

1. Beta-Tester Questionnaire