JA Clinic

We are running a very exciting research project on behalf of a leading car brand where you will get to preview some of the latest models before they are released!

The research will involve previewing a number of car models and giving feedback via an iPad - this will take approximately 2 hours and you will receive an £80 cash incentive as a thank you!.

Dates: 26th - 28th June

Duration: 2 hours

Times: Appointments available throughout the day and evening

Location: Wimbledon

Incentive: £80

If you are human, leave this field blank.

Call Comments

Agency Forensic Fieldwork Roots Research

Appointment Time - NEW TIMES Friday 26th June - 8.30am Friday 26th June - 9.30am Friday 26th June - 10.30am Friday 26th June - 11.30am Friday 26th June - 12.30pm Friday 26th June - 1.30pm Friday 26th June - 2.30pm Friday 26th June - 3.30pm Friday 26th June - 5.00pm Friday 26th June - 6.30pm Friday 26th June - 7.30pm Saturday 27th June - 8.30am Saturday 27th June - 10.00am Saturday 27th June - 11.30am Saturday 27th June - 1.00pm Saturday 27th June - 2.30pm Saturday 27th June - 4.00pm

Incentive Offered £80 £100

Booked as: Individual Couple - Insert Partner Name Booked as:

General Information

Please make any amendments necessary to the details shown below.

First Name *

Surname *

Mobile Contact Number

Alternative Contact Telephone Number

Email

Gender * Male Female Other

Do you or any of your family members/relatives work in any of the following industries or occupations? *

Automotive Manufacturer/Sales/Dealer

Automotive Parts/Repair

Tire Manufacturer/Import/Sales

Advertising/Market Research/Consulting

None of the above

Have you ever taken part in market research before? * Yes, in the last 6 months Yes, longer than 6 months ago No, never

What were the topics?

Which of the following age brackets do you fall into? * 19 years old or under 20 - 29 years old 30 - 39 years old 40 - 49 years old 50 - 59 years old 60 - 69 years old 70 - 75 years old 76 years old or over

What is your exact age? *

Do you have a car that you drive mainly? *

Yes

No

Car Brand *

Car Model *

How many doors does your car have? * 3 doors 5 doors

In which year did you buy your car? * 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 or earlier

In which month did you buy your car? * January February March April May June July August September October November December

Reg. No. *

Do reg. details check out on glass.co.uk/webuyanycar ? *

Yes

No

Is this car a ...? *

1 Private / Personal Car

2 Company Car

3 Taxi

Did you buy your car new or used? * 1 New 2 Ex-demonstration / Dealer Assured Used Car 3 Used Car

At the time you purchased/leased your car, which of the following best describes your role in the decision process? * 1 I was the primary decision Maker 2 The Decision was mainly mine but someone else provided input 3 I shared the decision equally with someone else 4 Someone else mostly made the decision, but I provided some input

How often do you drive your car? * Almost every day 4 - 5 times a week 2 - 3 times a week Once a week Less than once a week

Do you run any online forums or communities related to automobiles? * Yes No

Occupation

What is your occupation? * 1 Professional 2 Owner/Executive 3 Self-Employed 4 White Collar Employee 5 Blue Collar Employee 6 Homemaker 7 Student 8 Retired 9 Unemployed 10 Refuse to Answer

What city do you currently live in? *

Do you live in... * 1 In your own household 2 Not in your own household (e.g. sharing with relatives, parents, friends, etc.)

What is your current marital status? 1 Single 2 Divorced / Separated / Widowed 3 Married 4 Living with partner

Which of the following best describes your final level of full time education or training? * 1 Secondary school no qualifications 2 Secondary school with qualifications 3 Higher education (not university) 4 University - 1st Degree 5 University - Higher Degree

What is the total income of your household, including pensions and other benefits, before tax and other deductions? * 1 Up to £10,000 2 £10,000 - £19,999 3 £20,000 - £29,999 4 £30,000 - £39,999 5 £40,000 - £49,999 6 £50,000 - £59,999 7 £60,000 - £79,999 8 £80,000 - £99,999 9 £100,000 - £124,999 10 £125,000 and more

Please let us know your views on motoring in general

I like looking at beautiful cars * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I consider a car to be a means of transport rather than a source of pleasure * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

A highly versatile interior is important to me * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I would pay more to have the very latest safety technology * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

A car allows me to express my personality * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I like cars with classic lines and traditional styling * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I like cars with distinctive styling * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I see my car as my personal space where I can escape from the pressures of everyday life * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

The type of car I am driving needs to reflect my social position * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

I would like my car to be fitted with the latest entertainment equipment * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

For me cars are causing many of the environmental problems * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

As far as cars are concerned, I am always looking for an innovative model * 1 Agree Strongly 2 Agree 3 Disagree 4 Disagree Strongly

Finally

IF selected, would you be available to come back to the venue on Sunday to take part in a focus group? (£75 Incentive) *

Yes

No

You will need to bring along Photo I.D. and Original vehicle registration documents for you vehicle (i.e. V5) - can you confirm you will be able to bring these with you to the research? [You will not be able to take part without these] *

Yes, I will bring my V5

Yes, but I need to bring something other than V5. Record what they can bring instead:Yes, but I need to bring something other than V5. Record what they can bring instead:

No, I can't bring this