In-Person Vehicle Group
This questionnaire is a pre-screener to seek eligibility for a market research project. You do NOT get compensated for filling out this form. If you pre-qualify, you will receive a text or email from a Recruiter to call our office.  

Compensation: $150 Pre-Paid Visa or Amazon choice (if chosen) 

In-Person Atlanta Group - (area - Atlanta, GA 30340)
Fri/Oct 7th thru Sun/Oct 16th - 8:00am-8:00pm (30-45 min session MUST arrive 15-mins early)

In-Person Los Angeles (Torrance, CA 90501)
Fri/Sept 23rd thru Sat/Oct 1st - 8:00am-8:00pm (30-45 min session MUST arrive 15-mins early)

If chosen, MUST bring valid driver’s license, and vehicle Registration OR Certificate of Insurance with you on the appointed day.  If you wear glasses for reading, please remember to bring them.  

Everything you see and learn is confidential.  Because cell phones, watches, beepers, PDAs, cameras, and bags are NOT PERMITTED in the study area, please either leave these items at home or lock them in your vehicle prior to check-in.  Also, due to the limited amount of time and space at the facility, only invited guests will be allowed to participate.  Please plan to arrive a 15 minutes before your scheduled appointment time, if chosen.  

Compensation: $150 Pre-Paid Visa or Amazon choice (if chosen) 

Times are for reference only, booked by available quotas.
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Email *
First Name * *
Last Name *
Your Age * *
Your Age * *
What is your date of Birth? * *
MM
/
DD
/
YYYY
Gender * *
Ethnicity/Race * *
Required
Email * (if you have a Gmail account please enter that email address, preferred) *
Best Number to Text * *
Cell Phone Carrier * *
Alternate Number
Advanced Opinions communicates via text may we text to communicate with you? * *
Advanced Opinions communicates via email may we email you to communicate with you? * *
State * *
The County you Live in (i.e., Lehigh) * *
Your Zip Code where you live * *
The Make/Model of your Cell Phone * *
Are you currently * *
If you are a Student, are you
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What is the highest level of education you have completed? * *
If you are currently working, please briefly describe your employment. (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
What is your job title? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
What is the name of the company/organization you work for? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
If you are currently working, what industry do you work in? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) *  If not applicable, enter N/A *
(IF MARRIED OR CO-HABITATING) What is your spouse or partner’s current occupation? What Industry are they currently working in? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) *Example: FT/Bus Driver/Transportation (If not applicable, enter N/A) *
What best represents your households annual income before taxes? (By this we mean all income brought into the home by all household members) * *
Which of the following best represents your current marital status? * *
Are you a parent/legal guardian.... *
If yes, how old are they? * *
Required
Do you currently own any of the following vehicles? *
ONLY SELECT THOSE YOU PERSONALLY OWN AND IF CHOSEN CAN BRING vehicle Registration OR Certificate of Insurance.
Required
What year is your primary vehicle? *
What is the make/model of your primary vehicle? *
ONLY SELECT THOSE YOU PERSONALLY OWN AND IF CHOSEN CAN BRING vehicle Registration OR Certificate of Insurance.
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