FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

What is your age?

Which of the following best describes your current employment?

Working full-time (more than 30 hours per week)
Employed part-time, working at least 20 hours per week
Retired
Homemaker
Student
Not working but seeking employment

If you work at a company how many employees are working at your firm?

1
2-5
6-10
11-20
21-50
51-100
101-250
251-500
501-1000
1001-5000
5001-10,000
10,000+

What is the annual revenue of your company?

Less than 10,000
10,000-50,000
50,001-100,000
100,001-250,000
250,001-500,000
500,001-1,000,000
1,000,000-5,000,000
5,000,000-10,000,000
10,000,001-50,000,000
50,000,001-100,000,000
100,000,000-500,000,000
500,000,000-1 Billion
1 Billion- 5 Billion
10 Billion+
Don't know

What is the industry of your company? (Ex: Healthcare, Professional Services, Retail, Wholesale, Manufacturing, Telecommunications, Fashion, Computer Hardware or Software, Pharmaceutical, Hospitality, Entertainment etc...... Please write in the industry.

Which of the following best describes your marital status?

Single (living alone)
Married
Living with partner
Divorced
Widowed

What are the ages of your children? If you have more then one child you can select muliple ages? If you do not have children, please select I do not have any children.

0-6 months
6 months-1 year
1 year - 5 years
6 years - 12 years
13-15 years
16-19 years
20+ years
I do not have any children

What is the main reason you participate in market research studies? (Ex: Money, Chance to meet others in my field, find them interesting, like to give my opinion etc... Please be brief but detailed.

Submit Your Responses