Nationwide Students Study Week of December 19th

Greetings! Plaza Research San Diego is conducting a nationwide telephone and internet research study for students age 15-69 and would like to see if you qualify. Qualified participants will be paid $50 for a 30-minute phone and internet interview.

Please fill out the survey below and we will get back to you if it looks like you will be a match for this exciting research study! Please note that all responses will be returned on a first-come, first-serve basis until the groups are filled. Additionally, we may or may not contact you based on your answers given in this survey.

Thank you in advance for your interest and input!!

(YOU MUST ANSWER ALL QUESTIONS TO BE CONSIDERED FOR THIS SURVEY)

Question Title

* 1. Contact Info

First Name

Last Name

Phone Number 1

Phone Number 2

Age

Gender:

City, State

Email:

Question Title

* 2. In this current 2011-2012 school year, are you:

High School Junior

High School Senior

Parent of a High School Senior

Attending a two year community or junior college, a four year college or university, or a vocational or trade school

Question Title

* 3. What is your household's total annual household income?

$0 to $29,999

$30,000 to $50,000

$50,001 to $75,000

$75,001 or more

Question Title

* 4. What is your ethnic background?

Caucasian

African American

Hispanic

Asian

Other (please specify)