GfK Omnibus - Quick Quote Form

1.

Who do you want to interview?

Adults 18+

Teens 12-17

Hispanics 18+ Only

Other

2.

Sample size

1000
Other

3.

Method

	Telephone
	Online (General Online Popluation Only)

4.

Number of yes/no type questions

5.

Number of pre-coded (multi-choice) questions (6 pre-codes allowed per question unit)

6.

Number of rating scaled questions (3 statements/attributes per questions unit)

7.

'Other Specify' questions required?

	Yes
	No

8.

Number of open questions

9.

Custom banner required? (Demo banner standard at no additional charge)

	Yes
	No

10.

Is this for public release or proprietary information?

	Public Release
	Proprietary

11.

Results required by
Month Day Year

12.

Other pertinent information:

GfK Omnibus Services