Participate in a User Insight Usability Study

Sign up with User Insight and be among the first to preview new products. Your insights will help make the final product better.

For each session you participate in, you will be financially compensated. You may only participate once every 6 months. All sessions are taped so that they can be reviewed at a later time. For detailed directions to our lab locations, please view these Driving Directions.

Fill out as much of this profile form as you can. Only a few fields are required. This information is important to help us determine which products are most appropriate for you to review, and it will increase your chances of being recruited.

User Insight does not give or sell our participant list to anyone.

An asterisk (*) indicates required information.

Your Information

YOUR INFORMATION

*First Name:
Middle Initial:
*Last Name:
Address:
City:
State:	click to select Not Applicable Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Flordia Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	ZIP Code:
County:
*Home Phone:		Work Phone:
Fax Number:		Cell Phone:
*E-mail Address:
*Ethnicity	Choose One Caucasian African American Asian Hispanic Other
Sex:	Female Male
Languages Spoken:
Marital Status:	click to select married single divorced widowed other
Do you Rent or Own your Home?
	Rent Own
Do you or anyone in your immediate household work for an advertising or market research company?
	Yes No
We want to recruit users from a variety of age groups. Please choose your Birth Month and Year from the menus.
	Month: click to select January February March April May June July August September October November December Year: click to 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
Do you have a child or children?
	Yes No
If you have a child or children, please enter their birthdate and gender information below. If not, you can skip to the next question.
Child #1	Year: click to 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 Gender: Female   Male
Child #2	Year: click to 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 Gender: Female   Male
Child #3	Year: click to 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 Gender: Female   Male
Child #4	Year: click to 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 Gender: Female   Male
Please tell us your household income range.
	0-25,000/year 25,000 - 49,999/year 50,000 - 74,999/year 75,000 - 100,000/year 100,000 +
What industry do you work in or what industry is your business in?
	click to select Advertising Marketing PR Education Finance Insurance Real Estate Government Military Aerospace Healthcare Pharmaceutical Biotech Manufacturing R&D Media Entertainment Arts Non-IT Professional Services Legal Non-Profit Charity Retail Wholesale Trade Software Hardware Telecommunications Travel Transportation Hospitality Web IT Professional Services Workforce Development Professional Training Other
What is your occupation?
What is the LEVEL of your occupation?
	click to select Executive Managerial Professional Secretarial Trade/Laborer
Who is your Employer?
Number of Employees at Your Company:
	click to select 1-9 10-49 50-99 100-500 500+
Size of Company in Worldwide Sales Volume:
	click to select Under 1 million 1 million to 99 million 100 million to 149 million 150 million to 499 million 500 Million +
How many times have you traveled in the past 12 months?
	click to select 0 1-2 3-5 6-8 9-10 more than 10
Do you travel mostly for:
	Business Pleasure Both Business and Pleasure
What are your favorite hobbies?
Where did you hear about User Insight?
	Referred by Friend / Colleague Internet Search Posting / Announcement Direct Mail / Email Other (please describe):

Your Technology Use

Your Technology Use

What software do you use most frequently at work and/or home? Please list the three most used pieces of software.
Please Rate Your Skill Level as an Internet User:
	Beginner Intermediate Advanced
Please Check All of the Following that Apply to You:
	I send email with attachments. I download purchased software. I use online or system support tools or help. I create folders, save and find files on my hard drive and use a word processor. I am familiar with more than 2 search engines. I give out my Credit Card Information online. I pay some or all of my bills online. I own a PDA (Personal Digital Assistant). I have been involved in the development of a website.
How long have you been using the Internet?
	Not at all Less than 2 years 2-4 years More than 4 years
Approximately how many hours a week do you spend on the Internet?
	Less than 10 10-20 More than 20
How do you connect to the Internet at home?
	Dial-Up Broadband/Cable Modem DSL T1 or Other
If you do have the internet at home, who is your Internet service provider (ISP)?
	AOL BellSouth Charter Communications Comcast Earthlink/Mindspring Joi  Other:
Have you ever purchased anything over the Internet?
	Yes (if yes, please describe your purchase below) No

We appreciate your time and look forward to working with you in the future.