In-Home Project Question Title * 1. Please provide your shopper ID (I.e., SShop001) or email Question Title * 2. Please provide your address. Question Title * 3. Please provide your phone number. Question Title * 4. In what type of home do you reside? Single-Family Home Townhome Apartment Other (please specify) Question Title * 5. Please select which of the following rooms are available for scanning in your home: Living Room Adult/Teen Bedroom Dedicated Home Office Kitchen Dining Room Game Room Child's Bedroom Bathroom Garage Other (please specify) Question Title * 6. Please select your current household annual income range: Less than $43,350 a year Between $43,351 and $130,000 a year Greater than $130,000 a year Question Title * 7. What is your primary ethnicity? White or Caucasian Black or African American Hispanic or Latin American South Asian Southeast Asian East Asian West Asian/Middle Eastern Other (please specify) Question Title * 8. Please select days of the week you can be available for this project: Monday Tuesday Wednesday Thursday Friday Not Available During the Week Question Title * 9. Please select times of day you can be available for this project: Dawn Daytime Dusk Night (After Dark) Question Title * 10. This project requires an adult age 18 or over be present for the duration of the mapping visit. Do you confirm that you will be present during the entire 4 to 5 hour scheduled appointment? Yes No Question Title * 11. This project requires that you remove or cover any photos or other personal identifying information in your home prior to the scheduled appointment. Are you able and willing to do this prior to the appointment? Yes No Question Title * 12. Do you know of any business owners with corporate offices who may be interested in this project? If so, please enter a name and contact information for each referral. For each company that agrees to, and successfully completes, this study, you will be compensated $50. Name of Business Owner Name of Business City and State of Business Email of Business Owner Phone of Business Owner Done