1.MURRAY HILL CENTER A NATIONAL MARKET RESEARCH COMPANY HAS BEEN COMMISSIONED TO INTERVIEW PARTICIPANTS FOR AN UPCOMING PROJECT. THIS WILL BE A 90 MINUTE IN HOME INTERVIEW. IF YOU ARE INTERESTED IN THE PAID ($200) PLEASE COMPLETE ALL OF THE FOLLOWING QUESTIONS

Name:

Company:

Address:

Address 2:

City/Town:

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:

2.This project will involve having a research team of 2 to 3 people coming to your home to conduct the interview. This interview will last approximately 90 minutes. The results of our study will help to improve the development of new products. We would very much appreciate to include your experiences and opinions in our study.
As part of our survey, we would like to take some photos or short videos during the interview and of your household items pertinent to the research. Please don’t worry about tidying up before the interview, we need to see the reality, and be assured that all photos/videos and your information will be kept strictly confidentially. In order to facilitate the analysis of our study, it would be very helpful for us to audio record the interview.

Are you willing to participate in our survey and do you agree that the interview will be recorded and that some photos and/or short videos are taken in your home in order to capture key moments during the interview?

Yes

No

3.What is your gender

Male 

Female 

4.Which of the following brackets does your age fall into 

Under 25 years

25 to 30 years

30 to 35 years

40 to 45 years

46 to 50 years

51 years +

5.What is the exact age of yourself and your spouse / partner 

Self

Spouse / Partner 

6.Are you or anyone in your close friends or family employed in the following industries

Automotive

Banks and Insurances

Construction

Public Service

Gastronomy

Market Research, Marketing and Advertising

Journalism

Public Relations

Manufacture or distribution of household goods esp. white goods

Department store / supermarket

Electronics store; shop for household goods

Textile/ clothing retail or manufacturing

Other industry/in none of these industries

7.When was the last time you participated in a market research study?

Within the last 3 months

4-6 months ago

7-12 months ago

More than 12 months ago

Have never participated in a market research study before

8.What is your current family status? Please choose the one that describes you best:

Married

Living with partner (not married)

Single

9.What is your sexual orientation 

Straight  - Heterosexual 

Gay / Lesbian 

Other 

Prefer not to answer

10.How many children live in your household on a permanent basis?

None

1 child

2 children

3 or more children

11.Into which of the following age group/s do the children that live in your household fall? Please select all that apply 

None - I do not have any children

Up to 3 years

4 to 6 years

7 to 10 years

11 to 14 years

15 to 18 years

Over 18 years

12.What is your current occupational status?

Working full-time

Working part-time

Not working

13.What is the current occupational status of your partner / spouse?

Working full-time

Working part-time

Not working

14.What is your current housing situation?

I/we live in a single detached house

I/we live in a semi-detached house

I/we live in a terraced house

I/we live in an apartment

15.FOR APARTMENT DWELLERS  - Which of the following statements best applies to your apartment? 

Not applicable - I am not an apartment dweller 

The size of my/our apartment does not allow me/us to buy ANY additional home appliances because they would not fit in

The size of my/our apartment does not allow me/us to buy additional LARGE home appliances because they would not fit in

My/our apartment is large enough to buy additional home appliances; fitting them in would not be a problem

16.Do you OWN the house/apartment that you are living in?

Yes

No

17.Into which of the following categories does the net annual income of your household fall?

Below $50,000

Between $50,000 and 75,000

Between $75,000 and 100,000

Between $100,000 and 125,000

Between $125,000 and 150,000

Between $150,000 and 175,000

Between $ 175,000 and 200,000

Over $200,000

18.Which of the following devices do you own in your household?

Oven

Stovetop range

Food processor

Microwave (oven)

Washing machine

(Tumble) dryer

Stand mixer

I do not own the appliances in my home / apartment

19.If you considered to buy new household appliances such as those listed in the previous question for your household, who will be responsible for the purchase decision making?

I would be solely responsible

I would be mainly responsible

I and my partner/somebody else would be jointly responsible (in approximately equal proportion)

My partner/somebody else would be mainly responsible

My partner/somebody else would be solely responsible

20.Who is responsible for doing the laundry in your household?

I am solely responsible

I am mainly responsible; my partner/somebody else helps to some extent I and my partner/somebody else are jointly responsible (in approximately equal proportion)

My partner/somebody is mainly responsible; I help to some extent

My partner/somebody else is solely responsible