Beverages Survey

Thank you for registering your interest in this new research on behalf of a Worldwide Beverages Company.


This innovative online research will give you the opportunity to voice your ideas for new drinks!


The research is in the form of an approximate 20 minutes online survey and is taking place on Thursday 4th June - Sunday 7th June 2015


For just 20 minutes of your time we are offering a £20 incentive!


Details as follows:


Date –Thursday 4th June-Sunday 7th June

Duration – approx 20 minutes

Incentive - £20 incentive

Type of research - Online Survey


These questions are not the online survey. This is to check your eligibility for the research, if you are successful with your application we will contact you with the link to the actual survey.


When completing the form please answer carefully and as honestly as possible, there are no right or wrong answers, all answers will be looked at individually when checking that you are applicable for the research.


If you do fit the profile of respondent that we are looking for, then one of our team will call you to book you in.


Please fill out the
following form

When completing the form please answer carefully and as honestly as possible, there are no right or wrong answers, all answers will be looked at individually when checking that you are applicable for the research.


If you are a good fit for the research, a member of the team will be in touch over the coming days with some more information!


Your Details

Your Details

Your Current Life Stage...

What are the age(s) of your children? (please tick all that apply)
Are you a British National, that is, were you born and raised in the UK? *

Your Employment...

Your Role...

Specific Questions...

Which of the following have you drunk at least once in the past 3 months?
Which brand of energy drinks do you buy/drink? Please tick all that apply...
When was the last time you consumed an energy drink?
How often do you drink energy drinks?
Which brand of Tea do you buy/drink? Please tick all that apply...
When was the last time you consumed a cup of Tea?
How often do you drink Fizzy drinks?
Which brand of Fizzy drinks do you buy/drink? Please tick all that apply...

How much do you agree or disagree with these statements?....

Your Contact Information...

Finally

Would you be happy to participate and complete an online survery?

This information will be held confidentially and securely by Roots Research Ltd in accordance with the Data Protection Act 1998 and Market Research Society Code of Conduct.

I understand that my information will only be used to provide me with the opportunity to participate in occasional paid research. I am aware that I am under no obligation to participate and I am entitled to have my data removed at any point. *
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