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. CONTACT INFO Please provide the following: Name * Address * Apt # if applicable City/Town * State/Province * ZIP/Postal Code * Email Address * Phone Number * Question Title * 3. Where in the country do you live? Southern CA Northern CA West outside of CA Illinois Midwest outside of Illinois South East Northeast Question Title * 4. Which age range do you fall into? Under 18 18-24 25-34 35-44 45-54 55+ Question Title * 5. What is your exact age? Question Title * 6. What is your gender? Man Woman Non Binary/Other Prefer Not to Say Question Title * 7. What is your ethnicity? White/Causasian African American Hispanic Asian Other Prefer Not to Say Question Title * 8. In the past 3 months, have you participated in any research about new television programs Yes No Question Title * 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.) Advertising Market Research Radio or television (including cable) Entertainment industry Press coverage of the media or entertainment industry None of the above Next
