*1.This survey is being conducted by Adler Weiner Research in order to determine your eligibility for a focus group or interview about which you have been contacted. At no point are your individual answers ever sold or shared with our clients (aggregate data or anonymized summaries of the overall survey information may possibly be shared with our clients, however). This survey serves solely as a means for screening. Once the project has been completed this data will be deleted.  For more information please see:
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Adler Weiner Privacy Policy(Required.)

I consent to Adler Weiner Research collecting, storing and processing my personal information for the purpose of determining my eligibility for this market research focus group or interview.

I understand and consent to the following: That should I be eligible for participation in this market research focus group or interview, my contact information (phone, email, and home address) may be shared with the client for purposes related only to this particular project and are not limited to: screening calls to further determine eligibility, sending of "homework" or pre-session assignments via email, allowing access to an online platform via email, or for in-home interviews conducted at your residence.

*2.CONTACT INFO Please provide the following:(Required.)

Name *

Address *

Apt # if applicable

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

3.What is your gender identity?

Male

Female

Non-Binary

Other (please specify)

4.What age range do you fall into?

Under 18

18-24

25-34

35-44

45-54

55+

5.What is your exact age?

6.What is your annual household income before taxes?

Under $30,000

$30,000-$49,999

$50,000-$79,999

$80,000-$99,999

$100,000-$149,999

$150,000+

7.What is your employment status?

Full Time

Part Time

Not Working

Student

Other (please specify)

8.What is your marital status?

Married

Single

Cohabiting

In a relationship/not cohabiting

9.Do you have children in your household?

Ages 0-4

Ages 5-10

Ages 11+

No Children in Household

10.We have to find people in certain jobs and careers. Do you or any of your close family work, or have worked, in the recent past in any of the following professions?

Publicity/Advertising Agencies

Creative and Design Agencies/Consultancies

Direct Marketing Consultancies

Media Independents

Outdoor Specialists (ie. Poster Advertising)

Public Relations

Publishing

Journalism (TV/Press/Radio)

Marketing/Market Research

Sales Promotion Agencies

None of the above

11.Have you participated in a focus group or one on one in depth interview with a market research company in the last 6 months?

Yes

No

12.Which, if any, of the following activities do you do at least once a month?

Dine out

Eat takeaway food, either delivered or that you pick up

Go to a gym

Watch YouTube content

Visit museums

Read books

None of the above