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What is your Email Address?

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What is your gender?

Male

Female

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What is your age?

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Which of the following best describes your race?

Are you of Hispanic, Latino or Spanish origin?

What is your annual household income before taxes (Salaries of everyone in your family combined)?

What is your current employment status?

Self-Employed; Business Owner

Full-Time Employee

Part-Time Employee

Retired

Student

Homemaker

Unemployed

Military

Disabled

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In which of the foloowing state do you live in?

Do you, or does anyone in your household, work in any of the following industries?

Which of the following best describes the industry that you, personally, work in?

Approximately how many employees work at your organization at your primary job(all locations)?

1

2-10

11-50

51-100

101-500

501-1000

1001-5000

Greater than 5000

I do not work/I do not know

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What is your job title, level or responsibility at your primary job?

What is your education level?

Middle School / Some High School

High school graduate

Some college or university

College graduate with a 2 year degree

College graduate with a 4 year degree

Master's degree

Other post high school vocational training

Doctorate

Completed some postgraduate

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Please choose the options that best describe your household:

I am pregnant/expecting a child within the next 9 months

I have one or more children under the age of 18 living in my household

I have one or more children aged 18 or older living in my household

I have no children in my household and I am not pregnant/expecting a child

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Please indicate the age and gender of your child or children.

What is the approximate annual revenue of the organization at your primary job?

In which job function/role do you work with your company?

Which of the following best describes what language is spoken in your household?

English all the time

English more than half of the time

Spanish and English equally

Spanish more than half of the time

Spanish all the time

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In your household, are you the person who makes most of the daily purchasing decisions?

Yes, I am

No, someone else makes the decisions

Share decisions equally

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What best describes your current household?

Rented apartment

Owned apartment

Rented house

Owned house

Farm

University Residence

Living with parents

Other

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Do you drive a car regularly?

Yes, I own a car/cars

Yes, I have access to a car/cars

Yes, I lease/have a company car

No, I don't have access to a car

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How often do you go to the movie theater?

Less than once a month

1-2 time per month

2-3 times per month

3-4 times per month

4-5 times per month

Five or more times per month

I don't go to movie theaters

Prefer not to answer

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Which of the following pets are present in your household?

What is your relationship status?

Single, never married

Married

Divorced

Widowed

Separated

Living with Partner

Decline to answer

Engaged

In a relationship but not living with partner

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Do you use a smart phone?

Yes, for business

Yes, for personal

Yes, for both

I don't own a smartphone

Required field

Which of the following is your favourite Drinks Brand?

Poison

Milton

Pepasa

Super 8

Unreal

Red Volcano

Toothiya

None of the Above

What is you favourite destination and Why? According to you what will you do at that place if you visit there?

(Please answer in brief, at least in a sentence or two.)

I agree that Opinion Fuse may share certain personal data it collected for my profile with its third party clients. I further agree that such third party shall be the controller of the profile data shared, and the data shall be subject to the privacy notice they will provide to in their survey.