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20-673 Household Products
Please complete this survey to determine your eligibility for a 3 day online bulletin board scheduled to begin on September 10th. If qualified and invited to participate, you will receive $100 for completing the study.
After you fill out the survey, we will send you a confirmation email if you initially qualify. Your information is kept strictly confidential and will not be used for anything other than to recruit you for THIS study. We will not be able to reach out to people who do not initially qualify for this study or if the study is now filled.
Please enter your name
First
Last
Email Address
Cell Phone Number
We will send you a text confirmation. If you do not wish to enter your cell phone and receive phone call confirmations at another number, please enter that.
Alternate Phone Number
In what state do you reside?
Select one for each
Select one...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
What is your 5-digit zip code?
Be specific
What is your age?
Enter a number
What is your gender?
Select one
Male
Female