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May I please have your phone number with area code (daytime)
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May I please have your phone number with area code (evening)
May I please have your email address (we promise not to SPAM you)
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What is your gender?
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Female
Male
In what year were you born? (enter 4-digit birth year; for example, 1976)
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4-digit birth year
What is your relationship status?
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Single and not dating
Single but dating several persons
Dating one person exclusively
Married
Cohabiting or engaged
Same sex relationship
Which of these best describe your ethnic background?
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Aboriginal, that is, Native American, Metis or Inuit
African / Black
Asian
European / White
Latin American / Hispanic
Middle Eastern
Other (please specify)
What is your current MAIN occupation? Even if you are on a sabbatical, maternity, illness or work-related accident leave, please specify your EMPLOYMENT.
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MANUAL WORKERS (Farmer, packer, unskilled worker, minor, fisherman, forest worker, etc.)
SKILLED, SEMI-SKILLED WORKERS (Bricklayer, truck driver, electrician, machine operator, mechanic, painter, plumber, etc.)
OFFICE WORKER (Cashier, office clerk, accounting clerk, secretary, etc.)
PERSONNEL SPECIALIZED IN SALES (Insurance agent, sales person, sales clerk, real estate agent, real estate broker, sales rep, etc.)
PERSONNEL SPECIALIZED IN SERVICES (Security agent, taxi driver, hairdresser, cook, clergy member, in the military, police officer, firefighter, etc.)
SCIENCE AND TECHNOLOGIES WORKERS (computer operator, programmer-analyst, technician, audio- technician, lab technician, etc.)
PROFESSIONALS (Archeologist, architect, artist, lawyer, banker, biologist, chemist, accountant, consultant, foreman, dentist, designer, etc.)
MANAGERS/ADMINISTRATORS/OWNERS (director, editor, entrepreneur, executive, manager, business person, politician, president, etc.)
HOMEMAKER
STUDENT (full-time or whose studies take up most of his/her time)
RETIRED (pre-retired or private means)
UNEMPLOYED (Unemployment, welfare)
Other
Other (please specify)
How did you hear about us?
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Do you know anyone else that would be interested in paid market research? Enter their name and we'll enter yours into our draw to win an iPad!
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