Upcoming Vehicle Study

Thank you for expressing interest in Smith Research's upcoming paid research study on the topic of Vehicles. By answering the following questions, we will determine if you would be a good fit for this study. Upon review, we will only call if we believe you may qualify.
If you would like to sign up to participate in future studies, you will be forwarded to our participant sign-up page once you have completed this questionnaire.

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* What is your first name? What is your last name?

First Name

Last Name

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* What is the best phone number for you to be reached?

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* In what city do you currently reside?

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* What is your e-mail address?

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* What is your age?

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* Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Multiple ethnicity / Other (please specify)

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* Do you currently own/lease a vehicle for personal use?

Yes