Question Title * 1. This survey is being conducted by Adler Weiner Research in order to determine your eligibility for a focus group or interview about which you have been contacted. At no point are your individual answers ever sold or shared with our clients (aggregate data or anonymized summaries of the overall survey information may possibly be shared with our clients, however). This survey serves solely as a means for screening. Once the project has been completed this data will be deleted. For more information please see:Right to Opt-Out InfoFinancial Incentive InfoAdler Weiner Privacy Policy I consent to Adler Weiner Research collecting, storing and processing my personal information for the purpose of determining my eligibility for this market research focus group or interview. I understand and consent to the following: That should I be eligible for participation in this market research focus group or interview, my contact information (phone, email, and home address) may be shared with the client for purposes related only to this particular project and are not limited to: screening calls to further determine eligibility, sending of "homework" or pre-session assignments via email, allowing access to an online platform via email, or for in-home interviews conducted at your residence. Question Title * 2. FOR IN PERSON RESEARCH:In order to gain admittance to the facility, you need to bring: A Photo ID Reading glasses if you need them Please make sure to self assess your health prior to the session and we ask that you cancel in advance if you are sick with Cold/Flu/Covid-19 symptoms. Frequently we do not allow cell phones, smart watches, cameras or any electronic/digital devices into the research. There is a possiblity you will be asked to leave your devices with our front desk team where they will be kept securely during the research. If qualified and based on these participation requirements, are you willing to participate in this in-person interview? Yes No Question Title * 3. Please fill in the following Name (First and last) City Zip Code Phone Email Question Title * 4. In which county is your permanent address? Los Angeles Orange County Ventura San Bernardino Riverside Other (please specify) Question Title * 5. With Which gender do you identify? Male Female Non-binary Other (please specify) Question Title * 6. To which age group do you belong? Under 18 18-24 25-27 28-30 31-37 38-43 over 43 Question Title * 7. What is your exact age? Question Title * 8. With which ethnicity do you most identify? Checkk all that apply White Black or African American Hispanic or Latino Asian or Asian American Other (please specify) Question Title * 9. Do you or any member of your family work for any of the following types of companies? Check all that apply For an advertising or creative agency For a market research firm or the market research department of a company For a fashion/apparel company (this includes manufacturing, distribution, consulting, marketing for a fashion company, etc.) In fashion retail None of the above Question Title * 10. Have you participated in a focus group or one-on-one interview in the last three months? Yes No Question Title * 11. What types of focus groups or one-on-one interviews have you participated in the last twelve months, if any? Question Title * 12. Which of the following best describes your current employment status? Employed Full Time (30+ hrs/week) Employed Part Time (Up to 30 hrs/week) Self-employed Freelance Full-Time Student Part-Time Student Stay-at-Home Parent Unemployed but looking for work Unemployed, not looking for work Retired Next
