Become a Research Study Participant There are two steps that are required in order for you to be eligible and to be invited to join our participants' panel: Step 1: Complete this registration form Step 2: Check your email for a verification/confirmation email. Step 3: Sign-in to your profile and complete the information that tells us who you are, what products you use, etc. Registration * Required Field *First Name *Last Name *Email *Cell Phone (10 digits phone) *Cell Phone Carrier Please Select ... AT&T Boost C Spire / Cellular South Cricket Wireless Google Fi Metro by T-Moible / MetroPCS Sprint Straight Talk Straight Talk T-Mobile Ting Tracfone U.S. Cellular Verizon Wireless Virgin Mobile Xfinity Mobile xx Don't Know / Refused xx None of the Above / Not Listed Please don’t send me text message Home Phone (10 digits phone) *Home Zip *Password (6 character minimum) *Verify Password *Birth Date (mm/dd/yyyy) *Gender   Female Male Nonbinary Other – Not Listed here *Which of the following best describes you? Please Select ... A. I am a Consumer B. I am a Small Business Owner C. I am a Business Executive D. I am a Business Professional E. I am a Creative Professional F. I am an Information Technology Professional G. I am a Physician H. I am a Nurse I. I am another type of Medical Professional J. I am a Support Group Leader or Advocate *Ethnicity Please Select ... American Indian, Eskimo Asian, Pacific Islander Black or African American Carribean Caucasian Chinese* Filipino* Hispanic/Argentina Hispanic/Bolivia Hispanic/Chile Hispanic/Colombia Hispanic/Costa Rica Hispanic/Cuba Hispanic/DomincanRepublic Hispanic/Ecuador Hispanic/El Salvador Hispanic/Guatemala Hispanic/Honduras Hispanic/Latino Hispanic/Mexico Hispanic/Nicaragua Hispanic/Panama Hispanic/Paraguay Hispanic/Peru Hispanic/Puerto Rico Hispanic/Spain Hispanic/Uruguay Hispanic/Venezuela Japanese* Middle Eastern Multi-Racial Other Refused West Indian *Marital Status Please Select ... Divorced Living with sign. Other Married Separated Single Unknown/Refused Widowed Education Please Select ... Associates Deg/2yr College College Grad/4yr Equivalency/GED High School Grad Less than High School Post Grad Deg/Adv. Deg Post Grad Work no degree Some College Trade/Technical School Household Income Please Select ... A. Under 15,000 B. 15-19,999 C. 20-29,999 D. 30-39,999 E. 40-49,999 F. 50-59,999 G. 60-69,999 H. 70-79,999 I. 80-89,999 J. 90-99,999 K. 100,000-199,999 L. 200,000-299,999 M. 300,000-399,999 N. 400,000-499,999 O. 500K to 1MM (selection added 06-2015) P. 1MM or more (selection added 06-2015) Unknown/refused Employment Status Please Select ... Business Owner (with 1 or more FT employees) Disabled / Not Working Full-time Homemaker/Housewife Not Working: Other Part-time Retired Self-employed / Freelance (no employees) Student Unemployed Job Title Occupation Please Select ... Please Select…… BC Custodial services BC Driver, mover BC Food services BC Health services BC Laborer BC Machine operator, assembler BC Personal services BC Protection services BC Skilled trade Blue Collar, Pink Collar Business Owner Farming Not employed Not employed - Homemaker Not employed - Retired Not employed - Student Not employed - Unemployed WC Administrative support WC Executive, manager, administrator WC Professional specialist WC Sales WC Technical specialist White Collar Industry Please Select ... Please select…… None\Not Working Financial Services: Accounting Advertising/Marketing/Public Relations Agriculture/Agri-business Arts Banking Communications/Media Technology Construction Education/Academic Employment/Human Resources Facilities Management Financial Services: Securities/Brokers/Analysts Foodservice Government (all levels) Health Care/Medicine Homemaking Hotel/Resort/Hospitality Insurance Internet Law Managed Care Management Consulting Manufacturing Media/Journalism Non-profit Advocacy Real Estate Retail Trade Telecommunications Transportation Travel/Tourism Wholesale Trade Other Creative (Artist, Music, Fashion, Design, etc). Military (New selection) Please select any other secondary language(s) you are fluent in: Arabic Cantonese English French German Hindi/Urdu Italian Japanese Mandarin Portuguese Spanish X - Other Your privacy is extremely important to us. Any information you provide will be used for research purposes only. The Recruit and Field Inc privacy policy can be found here: https://www.recruitandfield.com/dataprivacypolicy.