Batteries Study #1221

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* 1. Contact Information

First Name

Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Do you or any member of your household, a close friend, or relative, work for...

Advertising

Market Research

Marketing/RP

Other (please specify)

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* 3. When was the last time, if ever, you participated in a market research group discussion or one-on-one in-depth interview?

Within the past 12 months

Longer than 12 months ago

Never

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* 4. Gender:

Male

Female

Non-binary

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* 5. Age:

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* 6. Which of the following best describes your marital status?

Married

Single

Widowed

Divorced

Separated

Living with significant other

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* 7. Do you have any children under the age of 18 living in your household?

Yes

No