1. Introduction

1. First Name:

2. Last Name:

3. Age:

4. Gender:

5. Email Address (for email confirmation purposes only):

6. Phone Number:

7. What is your current employment status?

8. When was the last time, if ever, you participated in marketing research study, such as a consumer group discussion or an individual interview?

9. NOT COUNTING YOURSELF, how many people reside in your home?

10. Do you have children living at home?

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