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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:
Right to Opt-Out Info
Financial Incentive Info
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.
By proceeding, you certify that all answers provided in this application are truthful, accurate, and complete to the best of your knowledge. You also confirm that you have completed this application independently, without the assistance of AI tools, chatbots, or other external aids.
Please note:
The client reserves the right to disqualify and turn away any participant without compensation if any information provided is found to be untruthful, inaccurate, or generated by AI.
Do you agree with the conditions above?
Yes
No
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3.
CONTACT INFO
Please provide the following:
(Required.)
Name
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Address
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Apt # if applicable
City/Town
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State/Province
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ZIP/Postal Code
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Email Address
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Phone Number
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4.
Which gender do you identify with best?
(Required.)
Male
Female
Not listed
Prefer not to answer
5.
What age range do you fall into?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
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6.
What is your exact age?
(Required.)
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7.
Which of the following best describes you?
(Required.)
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other (please specify)
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8.
We are interested in talking to people with a variety of backgrounds. Have you, or have any members of your family, worked (either currently or at some point) in any of the following types of companies?
(Required.)
Advertising agency or public relations firm
Marketing research company
Video game development or video game platform industry
Industry analyst firm
Social media company
Broadcast industry or television station
Journalism / Online media
Movie production or film studio
Electronics, computer hardware or software industries
Automotive industry
Transportation industry
Health care industry (doctor, nurse, dentist, etc.)
Tourism industry
Energy-supply, including power and gas companies
Education, including teachers and administration
None of the above
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9.
Which of the following activities do you do regularly? (i.e., on a weekly basis)
(Required.)
Play video games on PC/console
Go shopping
Play games on my phone
Play organized sports
Read
Watch movies
Hike
Watch movies/TV through a subscription streaming service
None of the above
