FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

1. Do you own and use a mobile smartphone?

Yes
No

2. Which mobile device do you use?* Please provide brand and model

3. Do you own a laptop or desktop computer?

Yes
No

4. How often do you shop online? *

Never
Rarely
Regularly
All the time

5. What are your favorite online stores? Please list a few of your favorite stores.

6. Have you done research for insurance online?

Yes
No

7. What is your exact age?

8. Are you:

Male
Female

Q9. Which of the following best describes your marital status.

Single
Divorced
Married
In committed relationship

10. How many children live in your household?

11. Select your highest level of education:

Did not graduate high school
High school graduate
Some college credit, no degree
Associate degree
Bachelor's degree
Post-graduate degree

12. What is your current working status:

Full-time
Part-time
Full-time homemaker
Retired
Student

13. What is your job title and what industry do you work in?

14. Where in Indiana do you live?

15. What is your household income?

Less than $20,000
$20,000 - $34,999
$35,000 - $49,999
$50,000 - $59,999
$60,000 - $85,000
125,000 - $149,999
$125,000-149,999
$150,000+

16. Do you own or lease a car?

Yes
No

16A. How many vehicles do you own or lease?

17. Do you rent or own your home?

Own
Rent

18. Have you gotten an online insurance quote before?

19. Have you ever had to file an insurance claim before?

Yes
No

20. Are you willing to be filmed and photographed during the focus group?

Yes
No

Submit Your Responses