Technology Study #3939

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* 1. Contact Information

First Name

Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is your age?

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* 3. What is your DOB?

Month/Day/Year

Date

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* 4. What is your gender?

Male

Female

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* 5. Which of the following best describes the area where you live?

Urban / downtown

Suburban

Rural

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* 6. Do you have access to a computer or tablet that is capable of video conferencing (e.g. has a webcam, working microphone, and internet access)?

Yes

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* 7. Do you, or does any member of your household or any close friends work for currently, or have worked in the past for a…

Marketing research firm

The media, i.e., TV, radio, on-line

A telecommunications or Internet company

A company that manufactures, wholesales or retails consumer, electronic products, cell phones/wireless technology, cameras or computer hardware, software or peripherals

None of the above

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* 8. How many focus groups, one-on-one discussions, or other paid research projects have you participated in in the last 12 months

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* 9. When, if ever, was the last time you participated in a market research discussion group?

Less than 6 months ago

More than 6 months ago

Never

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* 10. What is your marital status?

Married

Single, living with partner

Single, not living with partner

Divorced

Separated

Widowed

Other

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* 11. What is your current employment status? Are you…

An owner of a business

Employed full time

Employed part time

Homemaker

Retired

Unemployed

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* 12. Which company do you work for and what is your current job title or role in the company?

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* 13. Do you have any children, under the age of 18, living in your household? If you share custody, include any children that live with you at least 50% of the time.

Yes