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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.
Please fill in the following
(Required.)
Name
Address
City/Town
ZIP/Postal Code
Email Address
Phone Number
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3.
With which gender do you identify?
(Required.)
Male
Female
Non-binary
Other (please specify)
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4.
To which age group do you belong?
(Required.)
Under 18
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60 or older
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5.
What is your exact age?
(Required.)
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6.
With which ethnicity do you identify?
(Required.)
White
Black or African American
Asian or Asian American
Hispanic or Latino
Other (please specify)
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7.
What city and zip code / postcode do you live in?
(Required.)
City
Zipcode
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8.
As we are looking for people with exposure to certain industries, do you or any member of your family work, or have ever worked, in any of the following industries OR organizations?
(Required.)
Yes
No
An advertising agency
Yes
No
Public relations firm
Yes
No
Marketing research
Yes
No
Electronics retailer
Yes
No
Video game related hardware or software industries
Yes
No
Provider, distributor, or retailer of financial services, or banking/investment products
Yes
No
Manufacturer, distributor, or retailer of healthcare or medical products/insurance
Yes
No
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9.
Have you participated in a consumer discussion group or in-home research session in the past 6 months?
(Required.)
Yes
No
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10.
What subjects have you discussed in focus groups or in-home research?
(Required.)
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11.
How would you best describe your employment status?
(Required.)
Employed part-time, less than 30 hours a week
Employed full-time, 30 or more hours a week
Full-time student
Not currently working
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12.
What is yourJob Title, Company Name and Industry?
(Required.)
Job Title
Company Name
Industry
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13.
Can you tell me which of the following online activities you participated in within the last 30 days? Check all that apply
(Required.)
Playing video games on a TV, computer, phone, tablet, gaming console or handheld gaming device
Checking/reading social media.
Posting photos or videos on Facebook, Instagram, Tik Tok, or other social media.
Reading online news.
Reading a blog.
Contributing to your own blog and/or vlog
Shopping online.
Streaming my own video game playing online and have a following doing so
Reading/posting product reviews.
None of the above
