SurveyMonkey Powered Online Survey

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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

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. Please fill in the following

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. With which gender do you identify?

Male

Female

Non-binary

Other (please specify)

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* 4. To which age group do you belong?

Under 18

18-24

25-34

35-44

45-55

56-64

Over 64

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* 5. What is your exact age?

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* 6. 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)

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* 7. 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

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* 8. 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?

	Yes	No
Marketing Research	Marketing Research Yes	Marketing Research No
Healthcare	Healthcare Yes	Healthcare No
Advertising, Marketing or Public Relations Firm	Advertising, Marketing or Public Relations Firm Yes	Advertising, Marketing or Public Relations Firm No
Technology	Technology Yes	Technology No
Media (i.e. TV, radio, entertainment industry, streaming service, gaming, newspaper)	Media (i.e. TV, radio, entertainment industry, streaming service, gaming, newspaper) Yes	Media (i.e. TV, radio, entertainment industry, streaming service, gaming, newspaper) No
Retail	Retail Yes	Retail No
Manufacturing	Manufacturing Yes	Manufacturing No
Telecommunications or Telephone Company	Telecommunications or Telephone Company Yes	Telecommunications or Telephone Company No
Social Media, Online or Internet Services – including digital marketing, social networking	Social Media, Online or Internet Services – including digital marketing, social networking Yes	Social Media, Online or Internet Services – including digital marketing, social networking No
Automotive	Automotive Yes	Automotive No
A cable or satellite television provider	A cable or satellite television provider Yes	A cable or satellite television provider No

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* 9. What is your Job Title, Company Name and Industry? If a homemaker please fill in for you partner. If retired please fill in information based on your last job.

Job Title

Company Name

Industry

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* 10. 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

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* 11. 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

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* 12. Which of the following activities do you do regularly? (i.e. on a weekly basis) Check all that apply

Play games on my phone or tablet

Go shopping

Play organized sports

Read

Watch movies

Cook

Hike

Garden

Watch movies/TV through a subscription streaming service

Play games on PC/console