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. CONTACT INFO Please provide the following: Name * Address * Apt # if applicable City/Town * State/Province * ZIP/Postal Code * Email Address * Phone Number * Question Title * 3. Where in the country do you live? Southern CA Northern CA West outside of CA Illinois Midwest outside of Illinois South East Northeast Question Title * 4. What is your gender? Male Female Non-Binary / I prefer to self-identify Question Title * 5. What is your exact age? Question Title * 6. In what age range do you fall Under 18 18-24 25-34 35-44 45-55 56-64 65+ Question Title * 7. Which of the following best describes you? American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Other (please specify) Question Title * 8. Which of the following best describes your household’s total monthly income, after taxes? Less than $25,000 $25,000 to less than $50,000 $50,000 to less than $75,000 $50,000 to less than $100,000 $100,000 to less than $125,000 $125,000 to less than $150,000 $150,000 to less than $250,000 $250,000 to less than $500,000 $500,000 to less than $1,000,000 $1,000,000 or more Question Title * 9. Have you, or have any members of your family, worked (either currently or at some point) in any of the following types of companies? Marketing Research Healthcare Advertising, Marketing or Public Relations Firm Technology Media (i.e. TV, radio, entertainment industry, streaming service, gaming, newspaper) Retail Manufacturing Telecommunications or Telephone Company Social Media, Online or Internet Services – including digital marketing, social networking Automotive A cable or satellite television provider None of the above Question Title * 10. What do you do for a living? Job Title: Employer: Industry: Question Title * 11. What is the highest level of education you have completed? Some high school High school graduate Currently in college Some college College graduate Some graduate school Graduate school Question Title * 12. For classification purposes, which of the following best describes your current employment status? 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 Question Title * 13. Which of the following activities do you do regularly? (i.e. on a weekly basis) Play games on my phone Go shopping Play organized sports Read Watch movies Cook Hike Garden Watch movies/TV through a subscription streaming service Play games on PC/console None of the above Next
