*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:
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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.By proceeding, you certify that all answers provided in this application are truthful, accurate, and complete to the best of your knowledge. You also confirm that you have completed this application independently, without the assistance of AI tools, chatbots, or other external aids. Lastly, you confirm that you live within the United States and are not suing a VPN to change your location in any way.

Please note: The client reserves the right to disqualify and turn away any participant without compensation if any information provided is found to be untruthful, inaccurate, or generated by AI.

Do you agree with the conditions above?

Yes

No

*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.Are you a head of your household?(Required.)

Yes

No

*5.What is your exact age and Date of Birth?(Required.)

Age:

DOB:

*6.Do you or any member of your immediate family or household work in any of these professions?(Required.)

A market research firm

An advertising or public relations company

Banking or finance

Education (teacher, administrator or assistant, etc.)

Manufacturing, distribution or sales of toys, games, or video games

Media (including social media, TV, newspaper, magazines, etc.)

Entertainment (including production or distribution of movies, shows, etc.)

A mass merchandiser (like Target, Walmart or Amazon)

None of the above

*7.When, if ever, was the last time you or anyone in your family participated in a market research discussion, interview or diary project?(Required.)

Within the past 6 months

More than 6 months

Never