Skip to content
1.
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
*
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?
(Required.)
Yes
No
*
3.
Please fill in the following
(Required.)
Name (First and last)
Address
City
Zipcode
Phone
Email
*
4.
With which gender di you identify?
(Required.)
Male
Female
Non-binary
Other (please specify)
5.
To which age group do you belong?
Under 18
18-24
25-34
35-39
40-44
Over 44
*
6.
What is your exact age?
(Required.)
*
7.
With which ethnicity do you identify?
(Required.)
White
Hispanic or Latino
Black or African American
Asian or Asian American
Other (please specify)
*
8.
When did you last take part in market research and what was/were the subject(s)?
(Required.)
*
9.
Do you or any members of your immediate family, household or close friends work in any of the following industries or have you studied any of the following topics (either now or in the past)? Check all that apply
(Required.)
Market Research, Sales, Marketing, Advertising, PR
Media, Journalism – including news organisations & content creators (podcasts, vlogs, Youtube etc)
TV/Film/Radio production, design, development
Manufacturing or distribution of confectionery or food
Supermarket/newsagents/convenience stores
Dietitian, nutrition, food technology or any other work related to dietetics
None of the above
*
10.
How would you describe your employment status?
(Required.)
Working full time
Working part time
Full / part time student
Retired
Unemployed
Stay at home parent
Other (please specify)
*
11.
Which of these statements best describes your living situation?
(Required.)
I live alone (or with housemates) in my own home
I live alone (or with housemates) in a rented home
I live with my partner (and kids, if relevant) in my own house
I live with my partner (and kids, if relevant) in a rented home
I live in my parent’s or other relative’s home
*
12.
What is your annual household income
(Required.)
Under $35,000
$35-49,999
$50-75,999
$76-79,999
$80-99,999
$100K+
*
13.
What language do you predominantly speak?
(Required.)
English
French
Spanish
Italian
Other (please specify)
*
14.
Do you have any children - either living with you or with someone else, as part of the family that you are responsible for?
(Required.)
Yes
No
