November 20th Study Survey

Question Title

* 1. What is your age?

Under 18

18-24

25-34

35-40

41-45

46-50

50+

Question Title

* 2. What is your gender?

Male

Female

Third gender/Non-binary

Prefer to self-describe

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* 3. For statistical purposes ONLY, what is your current household income?

Less than $25,000

$25,000 to less than $50,000

$50,000 to less than $60,000

$60,000 to less than $70,000

$70,000 to less than $80,000

$80,000 to less than $90,000

$90,000 to less than $100,000

$100,000+

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* 4. What is the highest degree or level of school you have completed? If currently enrolled, highest degree received.

Nursery school to 8th grade

Some high school, no diploma

High school graduate, diploma or the equivalent (for example: GED)

Some college credit, no degree

Trade/technical/vocational training

Associate degree

Bachelor’s degree

Master’s degree

Professional degree

Question Title

* 5. Do you or any member of your household work in any of the following occupations?

Advertising or public relations

Marketing or market research

A bank or financial services company

A magazine, newspaper, or other type of written periodical

A radio, TV or other type of broadcast company

None of these

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* 6. Do you have a bank account?

Yes

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* 7. How often do you watch TV?

Every day

A few times per week

Once per week

Less than once per week

Never

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* 8. Which of the following brand of cards do you have in your wallet? Please select all that apply.

American Express

Mastercard

Discover

Visa

Capital One

Other type of card

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* 9. Of the previously chosen brands of cards, which do you use the most?

American Express

Mastercard

Discover

Visa

Capital One

Other type of card

Question Title

* 10. Please select which, if any, of the following you have experienced or currently experience. (Select all that apply)

Epilepsy

Frequent Migraines (more than 1 per month)

High blood pressure

Diabetes

Other neurological disorder

None of these

Question Title

* 11. During the session you will wear a small cap (similar to a shower cap) that measures brain activity or “brain waves”. The caps do not generate any electricity, are completely safe and have no effect on the wearer. During the session, you will view the TV program through a set of glasses (similar to virtual reality goggles). While viewing the program, you will also see a flickering white light on either side of the screen that is generated by the glasses. If you wear glasses, this is not a problem as the “goggles” can be worn over the top / in front of your glasses. But if you suffer from migraines, epilepsy or other neurological disorder, just to be safe it is not recommended that you participate. Do you understand and agree to participate?

Yes

Question Title

* 12. Do you wear braids, a wig, dreadlocks or gel in your hair? If, yes do you agree to not wear them on the day of the study? We ask this because these things can impede the signals to the cap.

I do not wear any of them

I do wear them and agree to not wear them on the day of the study

I do wear them and would still wear them on the day of the study