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Thank you for your interest in participating in our research panel. Please take a few minutes to answer the following questions and we'll add you to our database. |
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| FIRST, PLEASE VERIFY YOU'RE HUMAN! | | |
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* In what year were you born? |
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Year | |
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| * In what city or town do you live? | | |
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* Do any of the following types of people live in your household? (Select all that apply) |
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* What type of Chronic Disease or Mental Illness do you or others living in your household have? |
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* Please select which of these best describes your type of employment? |
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* Please select which of these best describes your partner or spouse's type of employment? |
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* Which of these best describes the industry in which you work? |
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* And which best describes the industry in which your spouse or partner works? |
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| If you have a LinkedIn Profile, please enter it below to be considered for executive or business studies or press next to skip. You may cut and paste. Note all LI addresses start with https://www.linkedin.com/in/ | | |
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* And finally, what is your approximate annual household income? |
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