Digital Research, Inc. : Panel : Join Today!

Join Today!

Thank you for your interest in joining our Consumer Technology Panel™. As a Panel Member,
you and the other members of your household will have the opportunity to participate in a
variety of fun and interesting opinion polls and product tests.

Cash and Prizes!

All of our client surveys involve Incentives to encourage your participation. In most cases, your
name will be entered into our Survey Incentive Sweepstakes, the winners of which receive
cash or merchandise. We encourage you to take a moment to view our Winners page.

Often times, when you participate in a product test, you will be allowed to keep the item for
your own enjoyment.

To join, simply complete our short application. Please answer every question completely.
This information is for research purposes only and will be held strictly confidential. Your
privacy is assured. We encourage you to take a moment to review our Privacy Pledge
before joining.

A Word About Minors

Occasionally, our work focuses on the attitudes, opinions and preferences of young people.
Respondents under the age of 18 may participate in our surveys only with the consent of an adult
member in the household.

When responses from minors are needed for a survey, we will ask adult members to discuss with
the minors in their household whether or not they are willing to participate.

If an applicant to the Panel indicates that he/she is under the age of 18, we will not process the
application. Instead, we will offer two means by which they can participate in our studies: Option 1 -
we will supply an online permission form that can be printed out, signed by an adult member of
the household, and returned to us. Option 2 - the applicant can ask an adult member of the
household to join our Panel and become the primary contact for that household.

These policies are consistent with those recommended by the Children's Advertising Review Unit
of the Council of Better Business Bureaus, Inc., the Children's Online Privacy Protection Act (COPPA)
and the Council of American Survey Research Organizations (CASRO).

DRI can accept this Panel Application only if you are 18 years of age or older.

Please Tell Us About Yourself

First Name:	Note: Please use upper/lower case
Last Name:
Street Address:
City:
State:
Zip Code:
Country:
Area Code:	Phone Number:
Your Primary E-Mail Address:	*
	* Please be sure your email address is correct! This is the primary means we will use to contact you. For example: jo_doe@aol.com; jane@inet.net
Age:	*Please do not leave blank. Must be 18 or over.
Date of Birth:
Gender:	Male Female
What is your ethnic background ?
Marital status
What is your annual household income?	*ALL information you submit is kept strictly confidential and is used for demographic and study qualification purposes only.
Please indicate highest level of education completed
What is your primary occupation?
If you selected "Other Occupation" please specify here:
How did you hear about our Consumer Technology Panel™?

Please Tell Us About Your Spouse/Significant Other  
(If no spouse/significant other, please click here.)

First Name:
Last Name:
Gender:	Male Female
Date of Birth:
Please indicate highest level of education completed
What is his/her primary occupation?
If you selected "Other Occupation" please specify here:

Please Tell Us About the Other Members of Your Household

Many of our projects consist of opinion polls or product/service evaluations that are intended for persons of a particular age and/or gender. Please provide background information on the other members of your household, so that we can select appropriate participants for our projects.

In the space provided, please indicate the total number of people in each of the following age groups currently living in your household - including yourself and your spouse/significant other. If a certain age group does not apply, you may enter "0" or leave the box blank.

0-2 years	3-5 years	6-8 years
9-12 years	13-17 years	18 and up

Please provide the following information for all household members (other than yourself and your spouse/significant other.)

	Person 1	Person 2
First Name:
Last Name:
Gender:	Male Female	Male Female
Date of Birth:



	Person 3	Person 4
First Name:
Last Name:
Gender:	Male Female	Male Female
Date of Birth:



	Person 5	Person 6
First Name:
Last Name:
Gender:	Male Female	Male Female
Date of Birth:

Please Tell Us About Your Computer Equipment

The following questions refer to the computers you use to connect to the Internet at home and/or at work.

Primary Home Computer
Don't own a home computer?	PLEASE CLICK HERE
Web Browser:
Operating System:
Internet/Modem speed:

Primary Office Computer
Don't use an office computer?	PLEASE CLICK HERE
Web Browser:
Operating System:
Internet/Modem speed:

The following question has two parts. Please respond to them both. At which locations do you have access the Internet? (check all that apply)

AND

Which ONE of the locations do you most often use to access the Internet? (check one)

	Have Internet Access (check all that apply)	Most Often Use (check one)
At home
At work
At school
At friend or family member's home

Which software application do you use to read your email? If you use more than one, please select your PRIMARY email application.

HTML Enhanced

Microsoft Outlook or Outlook Express
Netscape
Web-based Email (i.e. Hotmail)
Other HTML Reader (i.e. WebTV)

Plain Text

Microsoft Other
AOL
cc:Mail
Eudora
Lotus Notes
Other Plain Text

Finally, Please Tell Us About Your Use of Other Technologies

Which of the following technologies do you regularly use? (check all that apply)

Caller ID
Cellular Phone
Pager
Video Game Console (i.e. Sony PlayStation, PS2, Nintendo64)
Camcorder
Digital Camera
Scanner
Palm or other handheld organizer
Windows CE Palmtop
DVD Player
Digital cable/Satellite TV
Laptop computer
MP3 Player

THANK YOU FOR COMPLETING THE DRI CONSUMER TECHNOLOGY PANEL™ APPLICATION.

REMEMBER, ALL RESPONSES WILL REMAIN STRICTLY CONFIDENTIAL.

Once we process this application, you and other members of your household will be members of our online Consumer Technology Panel™. We thank you in advance for sharing your opinions. We hope you enjoy our projects and we look forward to working with you!

201 Lafayette Center, Kennebunk, ME 04043 USA

webmaster@digitalresearch.com