Please make sure your e-mail addresses are correct. This is the only way for us to contact you. For example: joe_doe@aol.com or jane@inet.net

1. Which of the following magazines do any of the adults in your household currently read or subscribe to? (Please check all that apply in each column.)

 

Magazines	Read	Subscribe to
American Baby
Baby Talk
Child
Cookie
Consumer Reports
FamilyFun
Fit Pregnancy
Kids/Martha Stewart Kids
Martha Stewart Living
Nick Jr. Family Magazine
Parenting
Parents
People
Real Simple
Scholastic Parent & Child
Wondertime
Working Mother
Other (Please specify: )


 
2. Which of the following magazines do your child(ren) read or subscribe to?

 

Magazines	Read	Subscribe to
American Girl
Boy’s Life
Comic Zone
Disney Adventures
Girl’s Life
Highlights
J-14
Mad Kids
National Geographic Kids
NeoPets
Nick/Nickelodeon
Sports Illustrated for Kids
Teen
Other (Please specify: )


 
3. Which of the following activities do you currently like to do on your own or with your child(ren)? (Please check all that apply.)

Visit the www.wondertime.com website
Visit the www.familyfun.com website
Visit the www.disneyadventures.com website
Visit the www.disneychannel.com website
Visit the www.disney.com website
Play ToonTown Online
Listen to Radio Disney
Watch the Disney Channel
Watch Toon Disney
Watch ABC Kids
Watch Jetix
Watch Playhouse Disney

4. For the child(ren) that you are signing up for the Disney Adventures Reader Panel, which of the following activities do they currently like to do? (Please check all that apply.)

Visit the www.familyfun.com website
Visit the www.disneyadventures.com website
Visit the www.disney.com website
Visit the www.disneychannel.com website
Play ToonTown Online
Read Disney Adventures magazine
Read FamilyFun magazine
Listen to Radio Disney
Watch the Disney Channel
Watch Toon Disney
Watch ABC Kids
Watch Jetix
Watch Playhouse Disney

5. Have you and/or members of your family visited any of the Disney theme parks, resorts or cruises listed below in the past 3 years? In the past year? (Please check all that apply)

 

Theme Park/Resort/Cruise	Visited in Past 3 Years	Visited in Past Year
Disney World (Florida)
Disneyland (California)
Disney’s California Adventure
Disney Cruise Line
Other Disney theme park/resort/cruise


 
6. Which of the following activities do the child(ren) that you are signing up for the Disney Adventures Reader Panel enjoy participating in? (Please check all that apply.)

 

	Playing video games (handheld or computer)		Going online (Internet)
	Participating in sports		Watching sports on TV
	Collecting (trading cards, dolls, stickers, etc.)		Cooking/baking for fun
	Hanging out with friends		Going to the movies
	Watching videos/DVDs		Watching their favorite TV shows
	Reading about their favorite celebrities		Reading books
	Reading comics		Doing puzzles & games (crosswords, word searches, mazes, etc.)
	Playing board games, trivia games, etc.		Working on hobbies and crafts
	Listening to music		Playing a musical instrument/singing
	Attending concerts by their favorite singers/bands		Taking care of pets
	Going to museums		Going to the zoo
	Shopping for groceries/food		Shopping for shoes or clothing
	Other (Please specify: )


 
7. Your date of birth:

Month: Please Select January February March April May June July August September October November December

Year: Please Select 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier

8. Your Gender: Male Female
    
9. Marital Status: Please Select Single (never married) Married Domestic Partnership Separated Divorced Widowed Other
    
10. Including yourself, how many people reside in your household?

Please Select 1 2 3 4 5 6 7 8 9 or more


 
11. Please indicate the birth month and year and gender of each person in your household, not including yourself. For each child that you are registering for the Disney Adventures Reader Panel, please also check the box labeled "Disney Adventures Panelist" and include their first name.

 

Person 2: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 3: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 4: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 5: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 6: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 7: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 8: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)

Person 9: Month Please Select January February March April May June July August September October November December   Year: Please Select 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 or earlier   Gender: Male Female   Disney Adventures Panelist?    (Please Enter Panelist's First Name:)


 
12. Please indicate the highest level of education that you have completed:



Please Select Grammar School High School Grad G.E.D. Some College 2 Yr College Degree College Graduate Master's Degree Doctoral Degree Professional Degree (MD, JD) Other

13. How many adults in your household are employed full-time?

Please Select 0 1 2 3 4 5 >5

14. What is your annual household income before taxes? Please Select Under $10,000 $10,000-19,999 $20,000-29,999 $30,000-39,999 $40,000-49,999 $50,000-59,999 $60,000-69,999 $70,000-79,999 $80,000-99,999 $100,000-124,999 $125,000-149,999 $150,000 or greater
     
15. To help us assure that we are communicating with you and not your child(ren) regarding any future survey invitations, please provide answers to the following security questions that only you would be likely to know the answers to. You will be asked one of these security questions each time we send you an invitation for one of your children to participate in a survey.

 

Name of your best friend in high school:

Make and model of your first car:

Year Graduated from High School: Please Select 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 or earlier

16. Digital Research, Inc. (DRI) maintains this Disney Adventures Reader Panel for Disney Adventures magazine. As a member of the Disney Adventures Reader Panel, we would like to invite you to join our own Online Research Panel. Belonging to both panels affords you a greater opportunity to let your voice be heard and make a difference! All of DRI’s research studies offer participation incentives that give you the chance to win valuable prizes. Your privacy is assured.

Would you be interested in joining the Digital Research Online Research Panel?

Yes
No