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$75 Taste Test (In Home)
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1.
Contact Info
(Required.)
Name
Phone
E-mail
Gender
Age
City
State
*
2.
Employment Status
(Required.)
Full time
Part time
Unemployed
Disabled
Retired
Homemaker
Student
*
3.
Current or Previous
(Required.)
Occupation
Industry
Company You Work For
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4.
Ethnic Background
(Required.)
American Indian or Alaska Native
Asian or Asian American
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or other Pacific Islander
White
Another race
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5.
Household Income
(Required.)
Under $15,000
Between $15,000 and $29,999
Between $30,000 and $49,999
Between $50,000 and $74,999
Between $75,000 and $99,999
Between $100,000 and $150,000
Over $150,000
*
6.
When was the last time you participated in a market research study either online, in person, through video, or over the phone?
(Required.)
• 0–3 months ago
• 4–6 months ago
• 7–9 months ago
• 10–12 months ago
• Longer than 12 months ago
• I have never participated in a market research study
