LeapFrog Mom Ambassador Screener Survey

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* 1. Contact Information

First and Last Name: *

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number:

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* 2. Please select your age group from the categories below.

18-29

30-39

40-49

50-59

60+

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* 3. Please indicate the number of children in your household.

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* 4. Please select the age of your children. Select all that apply.

Under 2

2-3

4-5

6-7

8-9

10-11

12-13

14-15

16+

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* 5. What is your family’s annual household income bracket?

Under $30,000

$30,000-70,000

$71,000-110,000

$111,000-150,000

$151,000+

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* 6. How would you classify your current career status?

Full time in-home working mother

Full time outside the home working mother

Part time in-home working mother

Part time outside the home working mother

In-home mother contributing no income to the family

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* 7. What kind of school(s) do your child(ren) attend? Please select all that apply.

Public School

Private School

Homeschool

Other (please specify)

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* 8. Please share links for your social media channels/accounts below.

Blog URL

Twitter

Facebook

Instagram

YouTube Channel

Other

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* 9. Please share metrics for your social media channels/accounts below.

Number of Average Monthly Blog Readers

Number of Twitter Followers

Number of Facebook Friends/Fans

Number of Pinterest Followers

Number of Instagram Followers

Number of YouTube Channel Subscribers

Other metrics you’d like to share

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* 10. Approximately how many moms do you communicate with OFFLINE on a weekly basis? (through school, PTA/PTO, moms groups, athletic leagues, etc.)

Under 20 Moms

20-50 Moms

50-100 Moms

Over 100 Moms

Over 1,000 Moms

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* 11. Please tell us about any other ways you connect with Moms. (Example: Playgroup and meet 30-40 moms each week or month; Write for a parenting publication that reaches 30K families each month etc.)

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* 12. Please indicate which of the following positions/titles that you hold and/or participate in. Please select all that apply:

Author

Columnist for offline publication

Columnist/contributor for online publication

Business owner

PTO leader

Church/Synagogue group leader

TV contributor

School board member

Local government/city position

Teacher/childcare professional

Coach

Other (please specify)

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* 13. Please indicate the frequency in which you cover the following topics on your social media channels.

	Daily	Weekly	Monthly	Bi-monthly	A few times a year	Never
Savings/coupons	Savings/coupons Daily	Savings/coupons Weekly	Savings/coupons Monthly	Savings/coupons Bi-monthly	Savings/coupons A few times a year	Savings/coupons Never
Crafting	Crafting Daily	Crafting Weekly	Crafting Monthly	Crafting Bi-monthly	Crafting A few times a year	Crafting Never
Recipes/cooking	Recipes/cooking Daily	Recipes/cooking Weekly	Recipes/cooking Monthly	Recipes/cooking Bi-monthly	Recipes/cooking A few times a year	Recipes/cooking Never
Fashion/beauty	Fashion/beauty Daily	Fashion/beauty Weekly	Fashion/beauty Monthly	Fashion/beauty Bi-monthly	Fashion/beauty A few times a year	Fashion/beauty Never
Fitness/healthy living	Fitness/healthy living Daily	Fitness/healthy living Weekly	Fitness/healthy living Monthly	Fitness/healthy living Bi-monthly	Fitness/healthy living A few times a year	Fitness/healthy living Never
Parenting	Parenting Daily	Parenting Weekly	Parenting Monthly	Parenting Bi-monthly	Parenting A few times a year	Parenting Never
Organization	Organization Daily	Organization Weekly	Organization Monthly	Organization Bi-monthly	Organization A few times a year	Organization Never
Green living	Green living Daily	Green living Weekly	Green living Monthly	Green living Bi-monthly	Green living A few times a year	Green living Never
Local family events	Local family events Daily	Local family events Weekly	Local family events Monthly	Local family events Bi-monthly	Local family events A few times a year	Local family events Never
Educational materials	Educational materials Daily	Educational materials Weekly	Educational materials Monthly	Educational materials Bi-monthly	Educational materials A few times a year	Educational materials Never

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* 14. Do you currently own any LeapFrog toys/products?

Yes

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* 15. Please indicate which of the following LeapFrog products you own. Select all that apply.

LeapTV

LeapPad (any variation)

LeapReader or Tag

Tag Jr

LeapBand

My Pal Scout or Violet

Other LeapFrog learning toys

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* 16. Have you ever participated in a LeapFrog blog review in-home party program?

Yes

I’m not sure

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* 17. How often do you discuss LeapFrog with family and friends?

Daily

Weekly

Monthly

Bi-Monthly

A few times a year

Never

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* 1. Contact Information

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* 2. Please select your age group from the categories below.

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* 3. Please indicate the number of children in your household.

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* 4. Please select the age of your children. Select all that apply.

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* 5. What is your family’s annual household income bracket?

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* 6. How would you classify your current career status?

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* 7. What kind of school(s) do your child(ren) attend? Please select all that apply.

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* 8. Please share links for your social media channels/accounts below.

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* 9. Please share metrics for your social media channels/accounts below.

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* 10. Approximately how many moms do you communicate with OFFLINE on a weekly basis? (through school, PTA/PTO, moms groups, athletic leagues, etc.)

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* 11. Please tell us about any other ways you connect with Moms. (Example: Playgroup and meet 30-40 moms each week or month; Write for a parenting publication that reaches 30K families each month etc.)

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* 12. Please indicate which of the following positions/titles that you hold and/or participate in. Please select all that apply:

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* 13. Please indicate the frequency in which you cover the following topics on your social media channels.

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* 14. Do you currently own any LeapFrog toys/products?

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* 15. Please indicate which of the following LeapFrog products you own. Select all that apply.

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* 16. Have you ever participated in a LeapFrog blog review in-home party program?

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* 17. How often do you discuss LeapFrog with family and friends?

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* 18. How do you feel LeapFrog has impacted your child(ren)’s life?

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* 19. Is there anything else you’d like to see from LeapFrog?

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* 20. Is there anything you’d like to tell us about why you’d like to be a LeapFrog Mom Ambassador?