Question Title * 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 InfoFinancial Incentive InfoAdler Weiner Privacy Policy 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. Question Title * 2. FOR IN PERSON RESEARCH:In order to gain admittance to the facility, you need to bring: A Photo ID Reading glasses if you need them Please make sure to self assess your health prior to the session and we ask that you cancel in advance if you are sick with Cold/Flu/Covid-19 symptoms. Frequently we do not allow cell phones, smart watches, cameras or any electronic/digital devices into the research. There is a possibility you will be asked to leave your devices with our front desk team where they will be kept securely during the research. If qualified and based on these participation requirements, are you willing to allow your child to participate in this in-person interview? Yes No Question Title * 3. Thanks again for your interest in the beverages study! The group will take place in Westwood for 90 minutes on Friday, May 16th. If your child qualifies and participates, he or she will receive $150Please check off which times, if any, your child would be available. If your child qualifies and we have a spot we will be in touch!Please keep in mind checking off times does NOT mean you are recruited for the project; you MUST be contacted by a recruiter. Friday, May 16th 4:15pm-5:45pm (Boys ages 13-14) Friday, May 16th 6:15pm-7:45pm (Girls ages 15-17) Friday, May 16th 8pm-9:30pm (Boys 15-17) My child is not available for any of these times Question Title * 4. CONTACT INFO Please provide the following: Name City/Town State/Province ZIP/Postal Code Email Address Phone Number Next
