Alloy Access > Welcome

Contact Info (*required questions)

First Name*		Last Name*

Address*		City*		State*		Zip Code*

Mobile Phone		Home Phone*

Email Address* (if multiple, separate by semicolons)		Instant Messenger Name

Best way to reach you?*
Mobile Phone		Home Phone		Email Address

Gender*				Birthday*		Ethnic Background* (select all that apply)
Male		Female		//		Please Specify: Please Specify: Language Preference:

School (*required questions)

What is the name of the last school you attended?*		Graduation Date* Month, Year		What hours are you in school?

Please describe any hobbies (clubs, sports, etc.).

What do you consider your family?*
	Upper Class
	Upper-Middle Class
	Middle Class
	Lower-Middle Class
	Lower Class

Do your parents give you spending money each month? If so, how much money do you receive?

Do you have a credit card?*
Yes		No

If you work, how much do you earn per month?

Where do you do most of your shopping?*
	Shopping mall
	Strip malls
	Department stores
	Specialty boutiques
	Outlet stores
	Thrift stores
	Flea market
	Other
Please Specify:

Do you own a digital camera? Answer yes or no.*
Yes		No

Are there certain products, ideas or services that you love and are always telling other people about?*
	Always
	Often
	Sometimes
	Rarely
	Never

When you last found a product, idea or service that you loved, how many people did you tell about it?*
	None
	1–4
	5–8
	9–12
	13–16
	17–20
	21 or more

In an average week, how many different people do you talk with on the phone (cell phone or home phone)?*
	1–5 different people
	6–10 different people
	11–15 different people
	16–20 different people
	21–25 different people
	26 or more different people

How comfortable are you talking with others about how you feel about new stuff?*
	Extremely Comfortable
	Very Comfortable
	Somewhat Comfortable
	Not Very Comfortable
	Not At All Comfortable

What was the coolest gadget you recently bought, and why?

Which new musician do you think is going to be popular soon? Why?

What is your favorite TV show? Why?

Mobile Details (*required questions)

Do you have a mobile phone? Answer yes or no.*
Yes		No

What make and model mobile phone do you currently own?		Who is you carrier?*
Make	Model

Which of the following have you done with your mobile phone in the last 3 months? Answer yes or no.*
a.	Made or received a phone call	Yes	No
b.	Sent or received a text message	Yes	No
c.	Sent or received an MMS or photo message	Yes	No
d.	Used your mobile phone to browse information or services	Yes	No
e.	Taken a photo with a camera contained in the phone or attached to it	Yes	No
f.	Downloaded a ringtone	Yes	No
g.	Created your own ringtone	Yes	No
h.	Downloaded a logo or icon for your phone	Yes	No
i.	Downloaded a game to your phone	Yes	No

When do you plan to replace your mobile phone?

In an average week, how many different people do you text using your mobile phone?*
	Do not have/use text messaging
	1–5 different people
	6–10 different people
	11–15 different people
	16–20 different people
	21–25 different people
	26 or more different people

For what purposes are you currently using text?
a.	Received a text advertisement or marketing message on your mobile phone	Yes	No
		From whom?
b.	Sent a text message to a TV show	Yes	No
		To whom
c.	Sent a text message to a radio show	Yes	No
		To whom?
d.	Subscribed to text alerts and information	Yes	No
		From whom?
e.	Sent a text message to a number printed on a product or its packaging	Yes	No
		To whom?
f.	Sent a text message to a number printed in a newspaper or magazine	Yes	No
		To whom?
g.	Sent a text message to a number shown in an advertisement of any kind	Yes	No
		To whom?

What types of information and interaction would you like to see in text? Please describe*.

Are you interested in participating in text campaigns from marketers or organizations? Answer yes or no.*
	Yes	No
	Why?	Why Not?

Referral

How did you find out about the panel? (If you were referred, please list your contact’s name.)*

Before submitting your Panel Application, please make sure all of the required questions (*) have been completed.