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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.
Are you currently working in or have you worked in any of the following occupations or industries within the past five years?
(Required.)
Advertising or branding
Marketing or market research
Sales promotion or public relations
Journalism or Media (i.e. TV, radio, newspaper)
Online Dating
Social media website, app or service
Web or App development & design
None of the above
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4.
Have you participated in a research study on any of the following topics in the past year?
(Required.)
Dating
Social connection
Sports
Food
Sleep
Shopping
None of the above
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5.
What is your age?
(Required.)
under 18
18-24
25-29
30 -34
35 and older
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6.
How do you identify?
(Required.)
Woman
Man
Transgender Woman
Transgender Man
Non-Binary
Gender Non-Conforming
Bigender
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7.
Do you consider yourself to be…?
(Required.)
Heterosexual/Straight
Asexual
Bisexual
Gay/Lesbian
Pansexual
Queer
A sexual orientation not listed here
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8.
Which races, ethnicities, or origins best describe you?
(Required.)
Hispanic or Latino
Black or African American
White
Asian or Asian American
Asian Indian or Indian American
Native Hawaiian or Other Pacific Islander
American Indian, Alaskan Native, or Indigenous
North African, Middle Eastern or Middle Eastern American
Other (please specify)
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9.
What is the highest level of education you’ve completed?
(Required.)
Some High School
High School
Some College
College
Some Postgraduate
Postgraduate
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10.
What is your current employment status?
(Required.)
Working full-time
Working part-time
Stay-at-home parent
Unemployed; looking for work
Unemployed; not looking for work
Retired
Student full-time
None of the above
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11.
What is your total household income before taxes?
(Required.)
Less than $15,000
$ $15,000 – $29,999
$ $30,000 - $49,999
$ $50,000 - $69,999
$$ 70,000 - $89,999
$ $90,000 - $99,999
$ $100,000 - $149,000
$ $150,000 - $199,999
$ 200,000+
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12.
What is your current relationship status?
(Required.)
Married
In a monogamous relationship
Single
Casually dating, but not in a relationship
In a non-monogamous relationship
Other
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13.
Have you ever used a dating app
(Required.)
Yes
No
