15818Grocery

Thanks for your interest in this study!

MFORCE Research is looking for men and women to participate in a paid consumer market research study regarding Grocery Shopping. The 2 hour groups will take place on Friday, Sept 28th in the morning and afternoon. The groups will be held at a facility in downtown Chicago, near the corner of Michigan & Wacker, where free parking is provided on-site.

Participants will receive compensation of $125 on a pre-paid Visa gift for the 2 hour group.

Please fill out the survey below. A recruiter will call you with some follow-up questions if it appears that we can place you in the study.

Question Title

* 1. About You.

Full Name

Exact Age

Daytime Phone Number

Email Address

Zip Code of primary residence

Question Title

* 2. What is your gender?

Male

Female

Question Title

* 3. Which of the following age groups do you fall within?

under 21 years old

22 to 25

26 to 30

31 to 38

39 – 53

54 – 64

65+

Question Title

* 4. What is the highest level of education you have completed?

Some high school or less

High school graduate

Some college

4 year college graduate

Post graduate or higher

Question Title

* 5. Which of the following best describes your current employment?

Employed full-time outside of the home

Employed part-time outside of the home

Work from home full time

Work from home part time

Stay-at-home parent/ homemaker

Currently unemployed

Question Title

* 6. Which of the following best describes your annual Household income before taxes:

Less than $40,000

$40,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,000 or more

Question Title

* 7. Would you tell me please which one of the following best describes your ethnic background?

Caucasian

African-American

Asian/Pacific Islander

Hispanic or Latino

Other (please specify)