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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.
What county do you currently reside?
Santa Cruz County
San Benito County
Monterey County
San Luis Obispo County
Santa Barbara County
Ventura County
Los Angeles County
Orange County
Riverside County
San Bernardino County
Other (please specify)
5.
What gender do you identify as?
Male
Female
Non-Binary
Other (please specify)
6.
What age range do you fall into?
Under 18
18-24
25-39
40-49
50+
7.
What is your exact age?
8.
We are looking for people who work in a variety of areas. Do you or does anyone in your immediate household work for ...
A news or media company such as television, radio or newspaper
A public relations company
An advertising agency or advertising department within a company
A marketing department within a company
A market research firm or a marketing research department within a company
A banking, financial, or investment institution
None of the above
9.
When was the last time you participated in a market research project (i.e., focus group discussion or one-on-one interview)?
Less than six months ago
Six months ago or more
Never participated before
10.
In the past 12 months, what were the subjects of any focus group discussions or one-on-one interviews you participated in?
If you didn't participate in the P12M, just put N/A
11.
Which of the following best describes your living situation?
Living alone
Living with a roommate(s)
Living with a partner or spouse
Living with parents
Other (please specify)
12.
When it comes to financial decision-making for your household, which of the following statements best describes you?
I am solely/mainly responsible
I share this responsibility equally with someone else
Someone else is mainly responsible
