*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.Please fill in the following(Required.)

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

*3.Which area of the country is your permanent residence?(Required.)

Northeast (Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, Connecticut, New York, New Jersey, and Pennsylvania)

Midwest OUTSIDE of Illinois (Ohio, Michigan, Indiana, Wisconsin, Minnesota, Iowa, Missouri, North Dakota, South Dakota, Nebraska, and Kansas)

Illinois

South (Delaware, Maryland, Virginia, West Virginia, Kentucky, North Carolina, South Carolina, Tennessee, Georgia, Florida, Alabama, Mississippi, Arkansas, Louisiana, Texas, and Oklahoma.)

West OUTSIDE of California (Montana, Idaho, Wyoming, Colorado, New Mexico, Arizona, Utah, Nevada, Oregon, Washington, Alaska, and Hawaii.)

California

*4.With which gender do you indentify?(Required.)

Male

Female

Non-binary

Other (please specify)

*5.To which age group do you belong?(Required.)

Under 18

18-24

25-34

35-44

45-54

Over 54

*6.What is your exact age?(Required.)

*7.With which ethnicity do you identify?(Required.)

White

Hispanic or Latino

Black or African American

Asian or Asian American

Other (please specify)

*8.Sometimes we need to speak with people who have and who haven’t been to market research studies in the past. This includes both online and in-person studies. When, if ever, was the last time you participated in a market research study?(Required.)

Less than 3 monts

3-6 months

6 mos - 1 year

Over a year ago

Never

9.If over three months ago: What was the topic of that study?

*10.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? Check all that apply(Required.)

Marketing Research

Advertising, Marketing or Public Relations Firm

Media (i.e. TV, radio, entertainment industry, streaming service, newspaper)

Telecommunications or Telephone Company

A cable or satellite television provider

None of the above

*11.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

*12.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

*13.What is your Job Title, Company Name and Industry (if you are a homemaker put partner's information and if you are a student put the name of your school and major)(Required.)

Job Title

Company Name

Industry

*14.Which of the following best describes your household income?(Required.)

Under $35,000

$35,000 - $49,999

$50,000-$74,999

$75,000-$99,999

$100,000

*15.On average, how many hours of content do you watch per week, on TV or streaming services?(Required.)

0-4

5-10

Over 10