1. SF Upcoming PAID Study on Computer Activities in the East Bay

Plaza Research has a research study coming up in which you may be interested in participating. Please complete this quick screening questionnaire so that we can verify your eligibility. We will then schedule appointments with qualified candidates on a "first come, first served" basis until the study is full.

To be considered for this study, you must be able to:
1. Participate in a 6-day diary-keeping activity (starting Monday, February 14th through Saturday, February 19th) which will require a commitment of 10-15 minutes per day to return diary feedback via an online form. You would receive a $100 honorarium for your participation.

2. Participate (if selected) in a 2 ½ hour interview at your home sometime on Tuesday, March 1st - Friday, March 4th. You would receive an additional $100 honorarium if selected for the in-home interview for your participation.

To participate you will need to:
--Be at least 18 years old
--Be willing to sign a Usability Non-Disclosure Agreement
--Allow the researchers to video tape the in-home session
--Live in the East Bay

Thank you for your time.

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* 1. Please provide your contact information below

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* 2. Please provide your employment information, if any

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* 3. Are you available to participate for both of these activities on the given dates as described above?

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* 4. If selected for the study, would you be willing to sign a Usability Non-Disclosure Agreement?

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* 5. If selected for the in-home visit, it is important for the research team to video/audio record the visit for reference when compiling the research report for this study. Is this acceptable to you?

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* 6. What is your gender?

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* 7. Which of these age groups do you belong to?

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* 8. What is your exact age? (i.e. 32)

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* 9. Which of these is the highest school level you've completed?

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* 10. We'd like to ask you about the work you do or whether you're currently studying. In the last month, (that is, the last 30 days) would you say you were:

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* 11. In what city and state do you currently live?

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* 12. Which of the following best describes your current living situation? Do you...

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* 13. Which of these email providers and/or personalized home pages, if any, do you use at least 2 times a week?

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* 14. As in the previous questions, there are no right or wrong answers. We're looking for people from all walks of life. Comparing yourself to your friends and family, how would you describe your knowledge about computers?

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* 15. Comparing yourself to your family/roommates or your friends, how would you describe your knowledge of or familiarity with the Internet?

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* 16. How many hours per week do you normally spend using the Internet (including email) for personal interest or entertainment?

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* 17. How many hours per week do you normally spend using the Internet for work or school? *Exclude time where email is just sitting open in the background.

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* 18. Thinking about a typical week and the kinds of devices you use to go online, do these devices include a computer that connects to the Internet?

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* 19. If you do use a computer that connects to the internet for going online, is this computer/any computers shared with others?

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* 20. If you do use a computer that connects to the internet for going online, is this computer/any computers exclusively for your use only?

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* 21. Do you use any other connected (i.e. able to connect to the internet) devices regularly, such as a mobile phone, ebook reader, game console, etc.?

Thank you for participating in our survey.
Please note that qualifying responses will be returned on a first come, first served basis until the studies are full.

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

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* 22. *******FOR OFFICE USE ONLY******

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