*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.

2.By proceeding, you certify that all answers provided in this application are truthful, accurate, and complete to the best of your knowledge. You also confirm that you have completed this application independently, without the assistance of AI tools, chatbots, or other external aids.

Please note: The client reserves the right to disqualify and turn away any participant without compensation if any information provided is found to be untruthful, inaccurate, or generated by AI.

Do you agree with the conditions above?

Yes

No

*3.Please fill in the following(Required.)

Name (First and last)

Address

City

State

Zipcode

Phone

Email

*4.Which area of the country is your permanent residence?(Required.)

Northeast (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania)

Midwest OUTSIDE of Illinois (Ohio, Michigan, Indiana, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas)

Illinois

South (Delaware, Maryland, Virginia, West Virginia, Kentucky, North Carolina, South Carolina, Tennessee, Georgia, Florida, Alabama, Mississippi, Arkansas, Louisiana, Texas, and Oklahoma.)

West OUTSIDE of California (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Oregon, Washington, Alaska, and Hawaii.)

California

*5.With which gender do you identify?(Required.)

Male

Female

Non-binary

Other (please specify)

*6.To which age group do you belong?(Required.)

Under 18

18-24

25-34

35-49

50-54

55-64

65+

*7.What is your exact age?(Required.)

*8.With which ethnicity do you identify? Check all that apply(Required.)

White

Black or African American

Hispanic or Latino

Asian or Asian American

Other (please specify)

*9.In the past 3 months, have you participated in any research about new television programs?(Required.)

Yes

No

*10.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? Check all that apply(Required.)

Marketing Research

Advertising, Marketing or Public Relations Firm

Media (i.e. TV, radio, entertainment industry, newspaper)

Telecommunications or Telephone Company

Social Media, Online or Internet Services – including digital marketing, social networking

A cable or satellite television provider

None of the above

*11.What are your hobbies or interests?(Required.)

*12.What is the highest level of education you have completed?(Required.)

Some high school

High school graduate

1-3 years of college

College graduate

Some graduate school

Graduate school

*13.Which of the following describes your household makeup?(Required.)

I am married or living with partner with no kids living at home

I am married or living with partner with kids under 18 years old who live with me

I am married or living with partner with kids over 18 years old who live with me

I am single and live alone

I am single and live with a roommate / parents

I am single and live with kids under 18 years old

I am single and live with kids over 18 years old

*14.What is your employment status?(Required.)

Employed full-time (or work 30 hours or more per week)

Employed part-time (or work less than 30 hours per week)

Retired

A homemaker

An unemployed student

Currently unemployed

*15.What is (was) your Job Title, Company Name and Industry?(Required.)

Job Title

Company Name

Industry

*16.Which of the following best describes your household income?(Required.)

Under $30,000

$30,000 - $49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$149,999

$150,000+

*17.On average, how many hours of video content do you watch per week? Please think about all the ways you watch, including live TV, streaming, on-demand, DVR, etc.?(Required.)

<1 Hour

1-4 Hours

5+ Hours