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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 Info
Financial Incentive Info
Adler Weiner Privacy Policy
(Required.)
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.
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2.
CONTACT INFO
Please provide the following:
(Required.)
Name
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Address
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Apt # if applicable
City/Town
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State/Province
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ZIP/Postal Code
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Email Address
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Phone Number
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3.
What age range do you belong to?
(Required.)
under 18
18-24
25-34
35-44
45-54
55+
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4.
What is your exact age and date of birth?
(Required.)
Exact age:
Date of birth:
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5.
What gender do you identify as?
(Required.)
Male
Female
Non-binary
Other (please specify)
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6.
What is your ethnicity?
(Required.)
White/Caucasian
Black or African American
Hispanic or Latino
Asian or Asian American
Other (please specify)
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7.
Where in the country do you live?
(Required.)
Southern CA
Northern CA
West Outside of CA
Illinois
South
Midwest
Northeast
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8.
In the past 3 months, have you participated in any research about new television programs?
(Required.)
Yes
No
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9.
Do you or does any member of your immediate family (SPOUSE, CHILD, OR PARENT) have any current or past employment history with any of the following industries?
Mark as MANY as apply. (Current or past employment with these industries)
(Required.)
Advertising
Market Research
Radio or television (including cable)
Entertainment Industry
Press coverage of the media or entertainment industry
None of the above
10.
Which of the following networks or streaming services do you watch content on?
Discovery Channel
Discovery+
CBS
FOX
Hulu
NBC
Amazon Prime Video
