Beverages 26-062 Survey

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.FOR IN PERSON RESEARCH:
In order to gain admittance to the facility, you need to bring:

A Photo ID
Reading glasses if you need them

Please make sure to self assess your health prior to the session and we ask that you cancel in advance if you are sick with Cold/Flu/Covid-19 symptoms.

Frequently we do not allow cell phones, smart watches, cameras or any electronic/digital devices into the research. There is a possiblity you will be asked to leave your devices with our front desk team where they will be kept securely during the research.

If qualified and based on these participation requirements, are you willing to participate in this in-person interview?(Required.)

Yes

No

3.Please fill in the following(Required.)

Name (First and last)

Address

City

Zipcode

Phone

Email

5.With which ethnicity do you identyify? Check all that apply(Required.)

a. Hispanic or Latino (Spanish, Mexican, Latin America: Colombian, Brazilian, etc., Caribbean: Cuban, Puerto Rican, Dominican, etc.)

b. White European (e.g. German, Irish, English, Italian)

c. Middle Eastern or North African (e.g. Lebanese, Turkish, Egyptian)

d. Black American or of African Descent (e.g. Jamaican, Haitian, Nigerian, Ethiopian, Somali)

e. Asian (e.g. Chinese, Taiwanese, Korean, Japanese, Vietnamese, Indian, Indonesian, Filipino, Thai)

f. Native Hawaiian or other Pacific islander (e.g. Samoan, Chamorro, Tongan, Fijian)

g. Native American, Inuit, or Aleut (e.g. Navajo Nation, Nome Eskimo Community, Cherokee)

Another race

7.What is your exact age?(Required.)

8.Are you or is any member of your immediate family currently employed in any of the following types of business? Check all the at pply.(Required.)

An advertising, marketing, or public relations firm

Marketing research firm

A newspaper, magazine, book publisher, blog, or website

An actor in commercials, TV or movies

A food or beverage manufacturer, packer, processor, wholesaler, or distributor

A restaurant, café, coffee shop or food services company

A grocery store

None of the above

9.Have you or anyone in your immediate family ever worked at any of the following companies? Check all that apply(Required.)

10.Have you participated in any market research, such as surveys, focus groups, discussion boards, or interviews that took more than 15 minutes in the past 6 months?(Required.)

Yes

No

11.Do you have Broadband or High-speed internet access, Smartphone (e.g., iPhone, Android) and a Laptop or Desktop computer WITH a working webcam in your household?(Required.)

Yes

No