VO!CE of the Region

Home

About the Panel

Join the Panel

Refer a Friend

Survey Results

eNewsletters

Join the Voice of the Region Panel

To become a panelist, please answer the questions below.

Already a member? Click here to refer a friend!

NOTICE: If you were referred to us by www.paidsurveys.com, www.homepay4you.com, www.paidsurveysonline.com, www.surveyscout.com, www.volition.com, or any other paid survey website we DO NOT pay respondents for online surveys or online focus groups.

However, if you live within the 10 county area surrounding Pittsburgh, Pennsylvania we do pay qualifying participants for focus groups that are conducted at our facility in Pittsburgh, Pennsylvania.

First Name
Last Name
Address

City
State
Zip Code
County
If OTHER, please specify:
Phone Number	- -
Email Address
Date of Birth	Month Day Year
Age Group
Gender
Race
Marital Status
Education
Are you a homeowner?
Are there children UNDER THE AGE OF 18 living in your household?
If you have children UNDER THE AGE OF 18 living in your household, enter the birth dates and gender of each child below:
Child 1 Month Day Year Gender
Child 2 Month Day Year Gender
Child 3 Month Day Year Gender
Child 4 Month Day Year Gender
Child 5 Month Day Year Gender
Child 6 Month Day Year Gender
Are you currently employed?
If employed or retired, which of the following best describes your occupation?
If OTHER, please specify:
If employed, where do you work?
If OTHER, please specify:
What is your annual household income?
Are you a registered voter?
If YES, what is your political affiliation?
Are you a smoker?
Do you use chewing tobacco?
Do you use public transportation?
Are you a pet owner?
If YES, what type of pet do you have?
Concerning the care of an older person, are you...?
Do you personally use a computer?
If you use a computer, do you have a webcam?
If you use a computer, do you have internet access?
If you have internet access at HOME, what type of access do you have?
If you have internet access at HOME, who is your Internet Service Provider?
What TV news station do you watch most often?
What radio station do you listen to most often?
If OTHER, please specify:
What is your primary bank?
If OTHER, please specify:
Who is your primary health care insurance through?
If OTHER, please specify:
Do you or anyone in your family take vitamins?
Do you or anyone in your family belong to a health club?
Do you or anyone in your family have Alzheimer's?
Do you or anyone in your family have arthritis?
Do you or anyone in your family have asthma?
Do you or anyone in your family have depression or anxiety?
Do you or anyone in your family have diabetes?
Do you or anyone in your family have gastric/intestinal disorder?
Do you or anyone in your family have high cholesterol?
Do you or anyone in your family have osteoporosis?
Do you or anyone in your family have eczema?
What is your primary service for daily news?
If OTHER, please specify:
Where did you first hear about the Voice of the Region?
If OTHER or referred by someone, please specify:
Know anyone else who might be interested in joining the Voice of the Region? Enter their information below!
First Name
Last Name
Email Address
Telephone Number

Respondent Bill of Rights.

Your participation in a legitimate marketing or public opinion research survey is very important to us, and we value the information you provide. Therefore, our relationship will be one of respect and consideration, based on the following practices:

Your privacy and the privacy of your answers will be respected and maintained.
Your name, address, phone number, personal information, or individual responses won't be disclosed to anyone outside the research industry without your permission.
You will always be told the name of the person contacting you, the research company's name and nature of the survey.
You will not be sold anything, or asked for money, under the guise of research.
You will be contacted at reasonable times, but if the time is inconvenient, you may ask to be re-contacted at a more convenient time.
Your decision to participate in a study, answer specific questions, or discontinue your participation will be respected without question.
You will be informed in advance if an interview is to be recorded and of the intended use of the recording.
You are assured that the highest standards of professional conduct will be upheld in the collection and reporting of information you provide.
Marketing and opinion research is an important part of our democratic society, allowing people to express their views on political and social issues, as well as on products and services.