Houston Studies - Mock Trial #2 October 2016

1. Deographic Section

Plaza Research Houston is conducting a Mock Trial for Montgomery County residents. The mock trial will take place at an off site location on Tuesday, October 11th, 2016 throughout the day. If you qualify and participate, you will receive $225 for 9 hours. Breakfast, lunch, and complimentary parking will be provided.

Please answer the questions below. If you look like a match, we will contact you by telephone.

**Due to the large response to our surveys, we are only able to contact those that look like a match. Please continue to answer future studies, as you may be a match to those.

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* 1. Please provide us with the following information. We will be contacting you by telephone if you seem like a match.

Name:

ZIP:

Email Address:

Phone Number:

Question Title

* 2. Alternate Contact number

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* 3. What is your Employment Status?

Please list the occupation, company and industry for all employed members of your household

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* 4. Are you male or female?

Male

Female

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* 5. What is your age?

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* 6. Which of the following best describes your current relationship status?

Married

Widowed

Divorced

Separated

In a domestic partnership or civil union

Single, but cohabiting with a significant other

Single, never married

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* 7. What is the highest level of school you have completed or the highest degree you have received?

Less than high school degree

High school degree or equivalent (e.g., GED)

Some college but no degree

Associate degree

Bachelor degree

Graduate degree

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* 8. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

American Indian or Alaskan Native

Asian

Black or African-American

From multiple races

Hispanic

Native Hawaiian or other Pacific Islander

White

Some other race (please specify)

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* 9. How much total combined money did all members of your HOUSEHOLD earn last year?

$0 to $9,999

$10,000 to $24,999

$25,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $124,999

$125,000 to $149,999

$150,000 to $174,999

$175,000 to $199,999

$200,000 and up

Prefer not to answer

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* 10. Do you have children under the age of 18 living at home?

Yes

If yes, please list the age and gender of each

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* 11. When was the last time, if ever, you did a market research?

Less than 3 mos

3-6mos

6-9mos

9-12mos

12mos+

Never

If so what was the topic, and where did you participate?