NFS Registration page (3.2)

GENEROUS RE-IMBURSEMENT FOR YOUR OPINIONS

Consumer research is a way for companies to obtain valuable feedback about existing and future goods and services. The way in which we conduct our research is by face to face interviews and/or group discussions held in a location near to you. We offer on average, between $35 - $80 (depending on the length of the session, which can vary from 1 - 2 hours) to cover your expenses in attending. Groups may involve observation techniques, such as viewing or recording. Please be assured that we just conduct research and do not promote or sell any products or services.

NFS is a member of the AMSRS (Australian Market and Social Research Society), & follows the standards, ethics, and guidelines defined by the MRSA. We also adhere to the National Privacy Principles, as laid out in the new Privacy Amendment (Private Sector) Act 2000. Your information is treated with the utmost confidentiality and is held in a physically secure and limited access database.

If you would like to be added to our database, to attend interviews and group discussions, please complete the questionnaire below. This questionnaire can be filled out by any person over 18 years of age.

Should you have any questions please don't hesitate to contact NFS on 1800 009 434

Note: Please answer as many questions as possible, the more information you can give us, the easier it is for us to match you to specific research projects.
+ If you wish to register for NSW or VIC Focus Groups, please go to www.consumerswanted.com

. . .

1.	Surname :
2.	Firstname :	Title:
3.	Address :

	Postcode :	State :
		...
4.	Telephone - Home :
5.	Telephone - Work :
6.	Telephone - Mobile :
7.	Email Address :
	Email Check Frequency :	Hourly Daily Weekly
	Group Area Preferred:
		...
8.	Occupation :
	Employeed Status :
	Self Employed :	No. of Employees:
	What is your partners occupation (if applicable)
		...
9.	Your Gender :
	Date of Birth :	Day / Month / Year

	Which Bank do you have your main account with :
		...
10.	These questions relate to your primary car:
	MAKE (ie. Holden) :
	MODEL (ie. Commodore) :
	Year of Manufacturer :
	Car insured with :
	Is this a company car :
		...
11.	Do you have pets:	Cat Dog
	Do you drink:	Beer: Wine: Spirits:
		Spirits: Spirits:

	Do you have any children living at home, if so what is their year of birth :	Child BOY, year of birth (YYYY): Child BOY, year of birth (YYYY): Child BOY, year of birth (YYYY): Child GIRL, year of birth (YYYY): Child GIRL, year of birth (YYYY): Child GIRL, year of birth (YYYY):
		...
12.	What is your current marital status :
	What is your current home status :
	In which category does the income of the entire household belong
	Are you the main grocery buyer :
		...
13.	Do you smoke cigarettes :
	Do you use the Internet :
	Do you have a swimming pool :
	Who is your Pay TV provider :
	Do you travel on business :
	Regarding general travel, is it :
	Do you have Private Health Insurance :

		...
14.	Main Credit Cards held :
	Your Occupation Grouping:
	Superannuation held:
	Gambling Preferred:
	Politics:
		...
	Where did you hear about us:


		Thank you