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MHNC-1620 National Consumer Finances
1.
Murray Hill National is seeking participants for a paid study, please fill out all the information below.
Name
Company
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Country
Email Address
Phone Number
2.
What age range do you fall into?
Under 18
18-29
30-49
50-65
Older than 65
3.
Which of the following best reflects your ethnic background?
Caucasian
Hispanic
African-America
Asian
Indian
Other (please specify)
4.
What is your marital status?
Married
Living with significant other
Single
Widowed
Divorced
5.
Who in your household is the primary decision maker for such things as insurance, banking and financial services?
My spouse/significant other
My spouse/significant other and I equally
Myself – I am the primary decision maker
Other (please specify)
6.
1. Do you or anyone in your household have any products or services with any of the following companies? (Examples include, but are not limited to, auto insurance, home owners, renters insurance, checking account, or credit cards.)
Bank of America
GEICO
Navy Federal Credit Union
Wells Fargo
USAA
Progressive
State Farm
Nationwide
JP Morgan Chase
All State
7.
Which of the following products or services do you or anyone in your household have from any of the companies we just mentioned?
Auto insurance
Property and casualty insurance (such as homeowner’s or renters Insurance)
Life insurance
A bank account (such as a checking or savings account)
Credit card or debit card
An investment account (such CDs, IRA’s, etc,)
8.
Have you or your spouse ever been rejected for a loan, credit card or insurance policy by any of the following companies?
Bank of America
GEICO
Navy Federal Credit Union
USAA
9.
Have you, your spouse, OR your parent's or spouses parents ever served in the United States Military?
Yes, I have served in the United States Military.
Yes, My spouse has served in the United States Military.
Yes, My parents OR my spouses parents have served in the united States Military.
No, Neither myself, my spouse, nor my parents or spouses parents have served in the United States Military.
10.
Would you willing AND have access to participate in a webcam interview?
Yes
No
