Reid Research - Web Registration

Web Registration Form

Our structure

Market Research : is a way for companies to gain feedback from the community about current or future products / services. Sessions are run in an informal setting, they go for between 30 & 60 minutes and people are paid cash or vouchers (between $20 to $50) for attending.

If you would like to be added to our database and contacted to attend Market Research sessions, please fill out the questionnaire below. Your information will only be seen & used by us and only for market research purposes.

^* Please answer as many questions as possible, the more information you can give us the easier it is for us to match you to specific market research project - Thanks.


1.	First Name :
2.	Surname :	Title:
3.	House No. & Street:
	Suburb:
	New Postcode :
	Venue Area Preferred:
		...
4.	Telephone - Home :
	Telephone - Work :
	Telephone - Mobile :	Plan:
	Mobile Plan with:
5.	Email Address :	* We may email you from time to time regarding sessions, enter 'OPT OUT' in the Email Address if you do not wish this to happen.
	Email Check Frequency:
6.	Your Gender :
	Marital Status :
	Ethnicity :
	Date of Birth :	Day(01-31) Month(01-12) Year(1900-)
7.	Job Title :	(10 characters max.)
	Employed Status :
	Self Employed :	No. of Employees:
	Which best describes your occupation :
8.	Do you drink ? (set all that apply) :	Beer Wine Spirits NON-Drinker
	Do you smoke :
		...
9.	Credit cards, (choose whichever apply) :

10.	What bank do you have your main account with :
	Have a Building Society account :	(10 characters max.)
	Bank account(s)	Savings Cheque Investment
		...
11.	These questions relate to your main car(s):
	Car Make :
	Car Model :
	Year of Manufacturer :
	Car insured with :	(10 characters max.)
	Is this a company car :
		...
12.	How many pets :	Cat Dog

13.	Do you have any children living at home, if so what is their year of birth :	Child BOY, year of birth (YYYY): Child BOY, year of birth (YYYY): Child BOY, year of birth (YYYY): Child GIRL, year of birth (YYYY): Child GIRL, year of birth (YYYY): Child GIRL, year of birth (YYYY):
		...
14.	Into which of the categories listed does the income of the entire household belong?
15.	Do you own a Personal Computer :
	Do you travel on business :
	Do you have Pay TV :
	Hear about us :
	Comments :
		Thank you

How we ensure quality

Endorsements

Contact details