Alcoholic Beverage Study

SIS International Research is conducting compensated focus groups about alcoholic beverage.

The focus groups will be held in Manhattan, NY on April 29th evening, and take around 1.5 hours.

The compensation is 125 dollars for those who qualify and participate in the research. Please complete a short pre-screening survey to be considered for this project.

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* 1. Contact Information

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Phone Number *

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* 2. What is your gender?

Male

Female

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* 3. Are you or anyone in your closest circle either currently working, or have previously worked/studied in any of the following professions?

Market research

Advertisement, PR

Newspaper, media, journalist

Working in the food sector

Employed by a company that manufactures/distributes or sells alcoholic beverages

Bar, café, restaurant, pub

Graphic or package Design

None of these

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* 4. May I please ask for your age?

Under 25

25-30

31-34

35-39

40-45

Over 45

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* 5. We’re looking for people from different backgrounds. Which of the following best describes your ethnic background?

African-American

Asian

Caucasian or White

Hispanic

American Indian

Other (please specify)

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* 6. Which best describes your marital status?

Single, never married

Living with significant other

Married

Divorced

Widowed

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* 7. Which of the following best describes your annual individual income?

Under $50,000

$50,000-$74,999

$75,000 – $100,000

$100,000 – $124,999

$125,000 – $149,999

$150,000 or more

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* 8. Please tell me which of these alcoholic beverages you drink in the last past year?

Beer

Vodka

Cognac

Port

Bourbon

Wine

Champagne

Scotch

Rum

Brandy

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* 9. Please tell me how often you consume each of these beverages?
Would you say, less than once a month, 2-3 times per month, 4-6 times per month, OR more than 6 times per month?

	less than once a month	2-3 times per month	4-6 times per month	more than 6 times per month
Beer	Beer less than once a month	Beer 2-3 times per month	Beer 4-6 times per month	Beer more than 6 times per month
Vodka	Vodka less than once a month	Vodka 2-3 times per month	Vodka 4-6 times per month	Vodka more than 6 times per month
Cognac	Cognac less than once a month	Cognac 2-3 times per month	Cognac 4-6 times per month	Cognac more than 6 times per month
Port	Port less than once a month	Port 2-3 times per month	Port 4-6 times per month	Port more than 6 times per month
Bourbon	Bourbon less than once a month	Bourbon 2-3 times per month	Bourbon 4-6 times per month	Bourbon more than 6 times per month
Wine	Wine less than once a month	Wine 2-3 times per month	Wine 4-6 times per month	Wine more than 6 times per month
Champagne	Champagne less than once a month	Champagne 2-3 times per month	Champagne 4-6 times per month	Champagne more than 6 times per month
Scotch	Scotch less than once a month	Scotch 2-3 times per month	Scotch 4-6 times per month	Scotch more than 6 times per month
Rum	Rum less than once a month	Rum 2-3 times per month	Rum 4-6 times per month	Rum more than 6 times per month
Brandy	Brandy less than once a month	Brandy 2-3 times per month	Brandy 4-6 times per month	Brandy more than 6 times per month

Question Title

* 1. Contact Information

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* 2. What is your gender?

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* 3. Are you or anyone in your closest circle either currently working, or have previously worked/studied in any of the following professions?

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* 4. May I please ask for your age?

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* 5. We’re looking for people from different backgrounds. Which of the following best describes your ethnic background?

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* 6. Which best describes your marital status?

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* 7. Which of the following best describes your annual individual income?

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* 8. Please tell me which of these alcoholic beverages you drink in the last past year?

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* 9. Please tell me how often you consume each of these beverages? Would you say, less than once a month, 2-3 times per month, 4-6 times per month, OR more than 6 times per month?

* 9. Please tell me how often you consume each of these beverages?
Would you say, less than once a month, 2-3 times per month, 4-6 times per month, OR more than 6 times per month?