* denotes required fields
1. How old are you? Under 21 22 - 24 25 - 34 35 - 44 45 - 59 60 or older
2. Are you a home owner? Yes No
3. Are you the primary decision maker when purchasing products for your home? Yes No
4. Which of the following activities have you have done in the past year? CHECK ALL THAT APPLY. written or called any politician at the state, local, or national level attended a political rally, speech, or organized protest of any kind attended a public meeting on town or school affairs held or run for political office served on a committee for some local organization served as an officer for some club or organization written a letter to the editor of a newspaper or magazine or called a live radio or TV show to express an opinion worked for a political party signed a petition made a speech written an article for a newspaper or magazine been an active member of any group that tries to influence public policy or government
5. Have you done any of the following in the past year? CHECK ALL THAT APPLY. Painted a room in your home Re-arranged one or more rooms of your home Redecorated one or more rooms of your home
6. Have you tried any new food, household cleaning, laundry, or housewares products that you saw advertised or in a store in the past year? CHECK ONE. Yes No
7. Have you recommended any new food, household cleaning, laundry, or housewares products to others in the past year? CHECK ONE. Yes No
8. Using a 10 point scale where "1" means you strongly disagree and "10" means you strongly agree, please indicate how much you agree or disagree with each of the following statements. [CHECK ONE PER ROW]
9. Using a 10 point scale where "1" means you strongly disagree and "10" means you strongly agree, please indicate how much you agree or disagree with each of the following statements. [CHECK ONE PER ROW]
