Online Focus Group Sign-Up

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We need to know something about you so that we will know which online focus groups and surveys you might qualify for. This information will be used only for research and never to try to sell you anything.
1. Please begin by providing your e-mail address. This will be used to notify you of upcoming surveys and online focus groups, so please make sure that the information is complete and correct.
2. Please tell us about your current work status.









3. Please select the category that best describes the industry in which you work.
4. Please choose the category below that best describes your title.









5. Please tell us about your level of decision making for each of the following types of products and services.
Determine the need Select the suppliers Both Neither Not sure
Travel arrangements
Automotive services
Business telecommunications
Copiers
PCs and related hardware
Software
Home web services
Web services
Wireless services
6. Education Level:







7. Please tell us about some of your personal interests. (Choose all that apply)



















8. What type of computer do you own or use most often? (Please choose one.)




9. To which of the following on-line services, if any, do you subscribe? (Please choose all that apply.)






10. How do you connect to the Internet?


11. Where do you access the www/Internet most often?




12. Gender?


13. Age Group?








14. Marital Status?






15. Number of children under 21 years of age living in your home?






16. What is your ethnicity?






17. For classification purposes, please estimate your total household income (net before taxes) for last year.






18. Mailing address (we need to know where to send the check)