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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.
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2.
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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3.
Where in the country do you live?
(Required.)
Southern CA
Northern CA
West outside of CA
Illinois
Midwest outside of Illinois
South
East
Northeast
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4.
What is your gender?
(Required.)
Male
Female
Non-Binary/Other
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5.
What is your exact age?
(Required.)
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6.
In what age range do you fall?
(Required.)
Under 18
18-24
25-34
35-49
50-54
55+
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7.
When, if ever, was the last time you participated in a market research study?
(Required.)
Never
less than 6 months ago
more than 6 months ago
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8.
What was the topic of the last market research study in which you participated? (If none put N/A)
(Required.)
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9.
Which of the following describes your household makeup?
(Required.)
I am married or living with partner with no kids living at home
I am married or living with partner with kids under 18 years old who live with me
I am married or living with partner with kids over 18 years old who live with me
I am single and live alone
I am single and live with a roommate / parents
I am single and live with kids under 18 years old
I am single and live with kids over 18 years old
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10.
For classification purposes only, please tell us which of the following best describes your ethnic background?
(Required.)
African-American or Black
Asian or Pacific Islander
Caucasian or White
Hispanic or Latino
Native American Indian
Other (please specify)
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11.
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.)
Marketing Research
Advertising, Marketing or Public Relations Firm
Media (i.e. TV, radio, entertainment industry, newspaper)
Telecommunications or Telephone Company
Social Media, Online or Internet Services – including digital marketing, social networking
A cable or satellite television provider
None of the above
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12.
What are your hobbies or interests?
(Required.)
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13.
What is the highest level of education you have completed?
(Required.)
Some high school
High school graduate
1-3 years of college
College graduate
Some graduate school
Graduate school
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14.
For classification purposes, which of the following best describes your current employment status?
(Required.)
I am employed full-time
I am employed part-time
I am a homemaker
I am a full-time student
I am retired
I am not currently employed
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15.
What kind of business are you or your spouse in if you are a homemaker?
(Required.)
Job Title:
Employer:
Industry:
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16.
Which of the following best describes your household income?
(Required.)
Under $30,000
$30,000 - $49,999
$50,000-$74,999
$75,000-$99,999
$100,000-$149,999
$150,000+
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17.
Does your household currently use any of the following streaming services?
(Required.)
Peacock
Amazon Prime Video
Discovery+
Hulu
Netflix
Paramount+
Disney+
YouTube Premium
Max (formerly HBO Max)
No: Do not subscribe to any of these services