SF Upcoming PAID study on ALCOHOLIC BEVERAGES - Feb. 8th

1. Alcoholic Beverages - Monday, February 8th

Thank you for taking the time to answer these brief questions. As always, we appreciate your input as a valuable Plaza Research respondent. We have a new study on ALCOHOLIC BEVERAGES that you maybe in interested in.

Please take note that you are ineligible to participate if you have taken part in any research study in the last 6 months.

We are looking for MALES ages 25-39 who consume alcoholic beverages. This study is a 2-hour focus group discussion and will take place in downtown San Francisco on Monday, February 8th. The honorarium is $125.00 if you qualify and participate.

IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone.

Please note that all responses will be returned on a first come, first served basis until the studies are full.

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* 1. Contact Information

Name

Cell Phone

Home Phone

Work Phone

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* 2. Employment Information

Job Title

Company Name

Industry

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* 3. IF MARRIED/LIVING TOGETHER
What is your spouse/partner's employment information

Job Title

Company Name

Industry

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* 4. What is your gender?

Male

Female

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* 5. Which of the following groups best fits your age?

24 or younger

25-27

28-30

31-33

34-36

37-39

40 or older

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* 6. What is your EXACT age?

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* 7. What is your current employment status?

Full-time

Part-time

Not working at all

Student

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* 8. IF MARRIED/LIVING TOGETHER
What is your spouse/partner's current employment status?

Full-time

Part-time

Not working at all

Student

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* 9. Which of the following beverages, if any, have you drunk in the past month? (SELECT ALL THAT APPLY)

Carbonated soft drinks, diet or regular

Bottled Water

Beer or Wine

Liquor or Spirits, that is other than Beer or Wine

Coffee or Tea

None of the above

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* 10. Which of the following best describes your ethnic background?

African-American

Asian-American

Hispanic/Latino

Caucasian

Other (please specify)

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* 11. What is your marital status?

Married

Single

Living with someone

Separated

Widowed

Divorced

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* 12. Do you have any children?

Yes. What is the age(s) of your child(ren):

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* 13. What was the last grade of school you completed?

Some high school or less

High school graduate

Some college

College graduate or beyond

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* 14. Which of the following best describes your total family income, before taxes?

$35k-$39,999

$40k-$49,999

$50k-$59,999

$60k-$74,999

$75k-$99,999

$100k or over

**IMPORTANT: PLEASE PUSH THE "DONE" BUTTON AT THE BOTTOM OF THIS SCREEN. YOUR ANSWERS WILL NOT BE SAVED WITHOUT DOING SO!**

Thank you for participating in our survey. IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

*****REFERRALS ARE GREATLY APPRECIATED!*****

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* 1. Contact Information

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* 2. Employment Information

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* 3. IF MARRIED/LIVING TOGETHERWhat is your spouse/partner's employment information

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* 4. What is your gender?

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* 5. Which of the following groups best fits your age?

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* 6. What is your EXACT age?

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* 7. What is your current employment status?

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* 8. IF MARRIED/LIVING TOGETHERWhat is your spouse/partner's current employment status?

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* 9. Which of the following beverages, if any, have you drunk in the past month? (SELECT ALL THAT APPLY)

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* 10. Which of the following best describes your ethnic background?

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* 11. What is your marital status?

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* 12. Do you have any children?

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* 13. What was the last grade of school you completed?

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* 14. Which of the following best describes your total family income, before taxes?

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* 15. ******FOR COMPANY USE ONLY****** (Please press next)

* 3. IF MARRIED/LIVING TOGETHER
What is your spouse/partner's employment information

* 8. IF MARRIED/LIVING TOGETHER
What is your spouse/partner's current employment status?

* 15. FOR COMPANY USE ONLY
(Please press next)