Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. 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. OK Question Title * 2. Please fill in the following Name City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 3. If you are a teen age 13-17 please provide your parent or guardian's name and contact information. We must get parental permission before we can contact you. If you are an adult age 18+ you can skip these questions. Parent/Guardian Name Parent/Guardian Email Address Parent/Guardian Phone Number OK Question Title * 4. What gender do you identify with? Female Male Non-binary Prefer to self describe Prefer not to answer OK Question Title * 5. What is your ethnicity? Select all that apply. White or Caucasian Black or African American Hispanic or Latino Asian or Asian American Native Hawaiian or other Pacific Islander Other Prefer not to answer OK Question Title * 6. Which of these categories best describes your total annual household income before taxes? Under $35,000 $35,000 - $49,000 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $149,999 $150,000 - $199,999 $200,000 or more Don’t know Prefer not to answer OK Question Title * 7. How old are you? 12 or under 13-17 18-24 25-44 45-65 66+ OK Question Title * 8. What is your exact age? OK Question Title * 9. Do you have kids ages 13-24 year old? Yes No OK Question Title * 10. If so, what age group and gender? Boy 13-17 Girl 13-17 Boy 18-24 Girl 18-24 OK Question Title * 11. Which area of the country is your permanent residence? Northeast (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania) Midwest (Ohio, Michigan, Indiana, Wisconsin, Illinois, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas) South (Delaware, Maryland, Virginia, West Virginia, Kentucky, North Carolina, South Carolina, Tennessee, Georgia, Florida, Alabama, Mississippi, Arkansas, Louisiana, Texas, and Oklahoma.) West (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, California, Oregon, Washington, Alaska, and Hawaii.) OK Question Title * 12. What best describes the area in which you live? Urban/City Suburban Small Town Rural OK Question Title * 13. Have you participated in any marketing research studies, focus groups, or usability studies in the last 6 months? Yes No OK Question Title * 14. Do you or anyone you live with work for an advertising or PR firm for a TV, radio, newspaper, social media or other type of media company for a public relations, marketing, or market research company for a large tech company such as Facebook, Google, Microsoft, Apple, or Amazon for a tech company None of the above OK Please note, if you are filling this out on behalf of your child, please make sure it is their answers to the following questions. Thanks! OK Question Title * 15. What type of mobile phone do you primarily use? Apple iPhone Android I don’t have a mobile phone Other OK Question Title * 16. What type of desktop computer operating system do you primarily use? Mac OS Windows Other (please specify) I don’t have a computer OK Question Title * 17. Which of the following social media apps do you use? (select all that apply) Facebook Instagram Snapchat Twitter Discord Line Houseparty Marco Polo GroupMe Squad TikTok None of the above OK NEXT
