1. Video Game Survey for Boys/Girls 12-15

Thank you for signing up with the Qualitative Insights database. We are currently looking for boys and girls between the ages of 6-17 to help conduct a study about video games in the near future:

* 1. Please tell me the age and gender of all your children 12-15 years old.

  Boy Girl Neither
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
12 years old
13 years old
14 years old
15 years old
16 years old
17 years old
Don't have children

* 2. What types of console video game systems do you have in your household and in working condition?

* 3. Which of the following best describes the type of school your child attends?

* 4. Which of the following best describes your child’s racial or ethnic background?

* 5. What is your total annual house hold income before taxes?

* 6. Please provide us with your contact information so that we may contact you: