Become a Panelist for GfK Strategic Innovation

Thank you for your interest in participating in one of our confidential market research studies.

As part of our ongoing work, we conduct market research to learn about, evaluate, and improve current and new products. We talk directly to consumers to get their input.

We do not sell anything
We collect opinions and compensate those who participate in this effort
We do not sell the names or information in our database to anyone (your infomation is kept completely confidential)

If this sounds like something you would like to be involved in, please take the time to fill out the form below. Please be careful to answer all questions - - leaving anything unanswered could leave out essential data used in choosing participants for specific projects. You will be asked to enter your personal and then your household information.

Once you submit this form you will be added to our database and we will keep you posted on upcoming research opportunities.

AT THIS TIME, WE ARE ONLY ACCEPTING PARTICIPANTS WITHIN DRIVING DISTANCE OF OUR ANN ARBOR, MICHIGAN FACILITY.

Thank you for your interest in participating in one of our confidential market research studies. As part of our ongoing work, we conduct market research to learn about, evaluate, and improve current and new products. We talk directly to consumers to get their input. We do not sell anything We collect opinions and compensate those who participate in this effort We do not sell the names or information in our database to anyone (your infomation is kept completely confidential) If this sounds like something you would like to be involved in, please take the time to fill out the form below. Please be careful to answer all questions - - leaving anything unanswered could leave out essential data used in choosing participants for specific projects. You will be asked to enter your personal and then your household information. Once you submit this form you will be added to our database and we will keep you posted on upcoming research opportunities. AT THIS TIME, WE ARE ONLY ACCEPTING PARTICIPANTS WITHIN DRIVING DISTANCE OF OUR ANN ARBOR, MICHIGAN FACILITY.
First Name:


Last Name:


Home Phone:


May we call you at work?

If yes, what is the phone number?


Do you own a cell phone?

If yes, what is the phone number?


Email:


Address:


City:


State:


Zip Code:


County:


Date of Birth (MM/DD/YYYY)


Race:

Gender:

Marital Status:

Highest Level of Education:

How many hours per week do you work?

What is your occupation:


Party Affiliation:

	Food Allergies	Asthma	BP/ Hypertension
Do you suffer from?



	High Cholesterol	Diabetes	Lactose Intolerant
(continued)



Next, a few questions about your household:
What is your total income?

	Dog	Cat	Other	None
What Pets do you own?




Do you live in a:

Do you:

Type of area you live in:

Do you regularly shop at/have a membership to a club warehouse store?

How many children under the age of 18 live in your household?

For each child in your household, please include the following information in order: Name - Date of Birth (MM/DD/YYYY) - Gender
Child 1:


Child 2:


Child 3:


Child 4:


Child 5:


Child 6:


Please enter the text in the image in the field below!

Become a Panelist

Next, a few questions about your household:

NewProductWorks