Parents with kids Study

First name

Last name

Email

Address

City

State

Zip code

What county do you live in?

Phone

Occupation

What company do you work for?

Ethnic Background

Marital Status

Highest Level of Education completed?

Income Level

Birthday * required

Do you have kids in the household under 18 years of age?

If you have kids what are their ages/ gender

Which of the following fast food / quick service restaurants, if any, have you been to in the past 3 months with your child/ren * Required

Burger King

Chick-fil-A

Chipotle

Culver’s

McDonald’s

Raising Cane’s

Wendy's

None

Which of these restaurants where you eat with your child/ren have you also used an indoor playground? * Required

Burger King

Chick-fil-A

Chipotle

Culver’s

McDonald’s

Raising Cane’s

Wendy's

None

When did you last participate in a group discussion or interview about a particular product or service?

What was the topic of your most recent research study you participated in?

Thanks for applying for our research project! We'll get back to you if we can use you for the study!

4.Culver’s

Superior Recruiting LLC

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