*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.

2.Thanks again for your interest in the Technology study! This study will take place on an Online Bulletin Board for three days from May 3rd-May 5th. It will be 45 minutes per day, 2.5 hours total. If you participate you will receive a $200 incentive.

Please check off if you'd be available to complete this online bulletin board on these dates. If you qualify and we have a spot for you we will be in touch!

Please keep in mind checking off availability does NOT mean you are recruited for the project; you MUST be contacted by a recruiter.

Sunday, May 3rd - Tuesday, May 5th for 45 minutes per day

I am not available to participate in this online bulletin board

*3.CONTACT INFO Please provide the following:(Required.)

Name *

Address *

Apt # if applicable

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

*4.Where in the country do you live?(Required.)

Southern CA

Northern CA

West outside of CA

Illinois

Midwest outside of Illinois

South

East

Northeast

5.What is your gender?

Male

Female

6.What age category do you fall under?

Under 17

18-24

25-34

35-44

45-54

55-64

65+

7.What is your age and date of birth?

Age

DOB

8.Have you, yourself, participated in a marketing research focus group or one-on-one interview in the past six months, or not?

Yes

No

9.What was the topic of the last focus group or one-on-one interview you participated in?

10.Are you, yourself, currently scheduled to participate in any marketing research studies at Adler Weiner Research or any other company?

Yes

No