SE3081/3082- fit test Question Title * 1. MURRAY HILL CENTER A NATIONAL MARKET RESEARCH COMPANY HAS BEEN COMMISSIONED TO INTERVIEW PARTICIPANTS FOR AN UPCOMING PROJECT. THIS WILL BE A 30 MIN LONG FOCUS GROUP AT AN EASY TO REACH LOCATION. IF YOU ARE INTERESTED IN THE PAID ($65.00) PLEASE ANSWER ALL OF THE QUESTIONS Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 2. Do you have a child that is 12 months old or younger? Yes No Question Title * 3. How old is your child-- please select the closest month 1 month 2 months 3 months 4 months 5 months 6 months 7 months 8 months 9 months 10 months 11 months 12 months Question Title * 4. Can your child sit up unassisted Yes No Question Title * 5. Can your child sit up unassisted Yes No Question Title * 6. How much does your child weigh 5-13 lbs 14-20 lbs 21-25 lbs 26-35 lbs Over 35 lbs Question Title * 7. How old are you? Under 17 18 - 24 25 – 34 35 – 45 46 – 54 55 - 64 65 + Question Title * 8. Which best describes your educational background? Did not finish high school High School Graduate Some College College Graduate Post Graduate Question Title * 9. What is your ethnicity? (Please select all that apply.) American Indian or Alaskan Native Asian or Pacific Islander Black or African American Hispanic or Latino White / Caucasian Prefer not to answer Done
