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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.
Where in the country do you live?
(Required.)
Los Angeles
Southern CA - Outside of Los Angeles
Northern CA
West outside of CA
Illinois
Midwest outside of Illinois
South
East
Northeast
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4.
For our research we need to speak to a variety of people, can you tell me if you or any member of your household had/have any of the following occupations?
(Required.)
Advertising
Marketing
Public Relations
Journalism
Media
Market Research
Financial Services
None of the Above
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5.
What is your age?
(Required.)
Under 18
18-20
21-24
25-35
36-40
41-50
51-54
55+
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6.
What is your exact age?
(Required.)
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7.
Do you identify as…
(Required.)
Man
Woman
Trans Man
Trans Woman
Gender non-conforming/nonbinary
Gender-fluid
Agender
Other (please specify)
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8.
And are you working…
(Required.)
Full time
Part time
Unemployed
Retired
Student
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9.
What is your occupation?
(Required.)
Job Title:
Company Name:
Industry:
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10.
What is your race/ethnicity? (Please select all that apply.)
(Required.)
American Indian or Alaska Native
Asian or Asian American
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or other Pacific Islander
White
Another race
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11.
Do you have BOTH stable internet/Wi-Fi connection and a smartphone, laptop, desktop, computer, or tablet to use to complete an online community with us?
(Required.)
Yes
No
Unsure
12.
Please select the sports that you currently follow or are a fan of...
Soccer
Football
Hockey
Basketball
Baseball
Tennis
None of the above
