1. Families Study - Tuesday, August 18th

Thank you for taking the time to answer these brief questions. We have a new study on FAMILIES that you maybe in interested in.

PLEASE DO NOT RESPOND IF YOU HAVE DONE A STUDY WITHIN THE LAST 6 MONTHS.

We are looking for males and females with child(ren) between the ages of 2.5 years old (30 months) up to no more than 4 years old (48 months or less). This study requires the attendance of you, your child, and the child's grandparent. Families in our study will get to use a new prototype system in a one-hour session in a research lab in Palo Alto on Tuesday, August 18th. There is an honorarium of $200.00 per family for participation.

Some families will be selected in participate in a 1-month in-home session. You will receive additional incentive if you are selected for the 1-month session. You, your child, and your child's grandparent MUST be available and agree to this possibility in order to participate in any part of this study.

IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

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* 1. Contact Information

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* 2. Employment Information

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* 3. What is your gender?

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* 4. Who lives in your household? (i.e., Wife, Husband, Child, Grandparent, Sister, Brother, Single, etc.)

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* 5. Do you have any child(ren) living in your household?

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* 6. If you do have children, what are your kids' NAME(S), AGE(S) and GENDER?

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* 7. What city do you live in?

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* 8. Do you have a parent (child's grandparent) that lives OUTSIDE of your household in the bay area?

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* 9. What city does your child's grandparent live in?

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* 10. Please answer yes or no to the following questions.

  Yes No I do not have any children or child does not have living
Do you have high-speed internet (as opposed to dial-up) at home?
Does the local grandparent have high-speed internet at home?
Do you have wireless internet at home?
Does the local grandparent have wireless internet at home?
Can the grandparent read an English children's book?
Does your child speak English?
Do the grandparent(s) and children typically communicate in English?
Do you read books to your kids in English?
Does your child watch Sesame St. or Elmo's World on Television?
Would your child recognize a picture or doll of Elmo?
Would your child recognize the voice of Elmo?

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* 11. What is your ethnic background?

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* 12. What income bracket best fits your total household income?

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* 13. Some families may or may not also be selected to participate in a 1-week in-home session (take the prototype home for 1-week followed by an in-person interview) and/or 1-month in-home session (phone interview check-ins of 5-10 minutes every week). Your family may not be selected; however, IF YOU ARE SELECTED You will receive additional incentive for either or both sessions. You, your child, and your child's grandparent MUST be available and agree to both of these possibilities in order to participate in any part of this study. Please select which weeks/months you will be available:

Thank you for participating in our survey. IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

*****REFERRALS ARE GREATLY APPRECIATED!*****

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* 14. ******FOR COMPANY USE ONLY******
(Please press "DONE")

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