1. Cars
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*
1
. Name
Name
First Name
Last Name
*
2
. Gender
Gender
Male
Female
3
. Work Phone Number
Work Phone Number
4
. Cell Phone Number
Cell Phone Number
*
5
. Best contact number between the hours of 9am-7pm
Best contact number between the hours of 9am-7pm
*
6
. Age
Age
*
7
. Email Address
Email Address
8
. Race
Race
White or Caucasian
Hispanic or Latino
Black or African-American
Asian-American or Pacific Islander
Native American or American Indian
Other (please specify)
9
. When was the last time you participated in a research focus group or one on one interview?
When was the last time you participated in a research focus group or one on one interview?
Less than 3 months ago
3-6 months ago
6-12 months ago
More than 1 year ago
Never
10
. Which of the following best describes your total household income, before taxes?
Which of the following best describes your total household income, before taxes?
Under $50,000
$50,000 to $60,000
$60,001 to $70,000
$70,001 to $80,000
$80,001 to $90,000
$90,001 to $100,000
$100,001 to $125,000
$125,001 to $150,000
$150,001 to $175,000
$175,001 to $200,000
$200,001 to $300,000
Over $300,000
11
. Please tell me the year, make and model of the vehicle(s) that you currently drive on a regualr basis?
Please tell me the year, make and model of the vehicle(s) that you currently drive on a regualr basis?
Car # 1 you drive - Year
Car # 1 you drive - Make
Car # 1 you drive - Model
Car # 2 you drive - Year
Car # 2 you drive - Make
Car # 2 you drive - Model
Car # 3 you drive - Year
Car # 3 you drive - Make
Car # 3 you drive - Model
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