, a market research firm, assists companies in learning what consumers need or want. We PAY people for their opinions on various products or services. Join thousands of Baltimore-area households who assist such companies as Johnson and Johnson and Proctor & Gamble create or improve their products. Projects occur on a periodic as needed basis.
I understand that by completing this form I may be called to participate in discussion groups, telephone or mail surveys. I also understand that this information will be held in the strictest confidence and will NOT be sold. We will never share, sell or rent personal information with anyone without your advanced permission. Compensation for each project varies.
General Information Name Address State Spouse Home Phone DOB City Zip DOB Work Phone Email Address	Marital Status Married Divorced Single Widow Other Work Information Your Occupation Work Location: (Balto.City, etc.) Spouse Occupation Work Location: (Balto. City, etc.)
Children's Names - Living at home Name M F DOB Name M F DOB Name M F DOB
Education: Less than High Sch. College Grad High School Grad. Some Post Grad. Some College Graduate Degree
Ethnicity: African American Hispanic Asian Native American Bi-Racial Other Caucasian
Spouse Education: Less than High Sch. College Grad High School Grad. Some Post Grad. Some College Graduate Degree
Spouse Ethnicity: African American Hispanic Asian Native American Bi-Racial Other Caucasian
Combined/Total Household Income: Less than $25,000 $45,001-55,000 $75,001-100,000 $25,000-35,000 $55,001-65,000 $100,001+ $35,001-45,000 $65,001-75,000             Medical Background: Please indicate if you OR anyone in your household has or has had any of the following conditions. Please check all that apply: ADHD Hypertension Asthma Osteoporosis Eating Disorder Arthritis Mental Health Illness Diabetes Allergies High Cholesterol Cancer Other: