Topical Issues in the Media and You!

Your Contact Details

First Name *

Surname *

Daytime Contact Telephone Number *

Alternative Contact Telephone Number

Email Address *

Your Current Life Stage..

Gender *

Please tell us which year you were born (e.g. 1980)

Do you have Children? *

What is your current living status? *

Which of the following best describes your current living situation?

Other (please specify)

What is your ethnic group?

Are you a British National, that is, were you born and raised in the UK? *

Yes

From which country do you originate?

How long have you been living in the UK?

Your Employment..

What is your employment status? *

You and your Transport..

Do you own/use a car? *

Yes

You and Your Car..

Vehicle - Make & Model

Car Type

Year of manufacture

Did you buy your car new or used?

Your Contact Information..

County *

Postcode

Nearest major city/town to your location *

This will be used as the location in which the research may take place (e.g group discussions), alternatively please select local research only and we will contact you for anything within your local area and telephone interviews.

Which Borough of London do in live in?

SCREENING: Current & Past Employment

SCREENING: Past Research

Your Voting Preferences...

Which Electoral Constituency are you eligible to vote in? *

At the 2012 Mayoral Election who did you vote for? *

At the 2010 General Election who did you vote for? *

At the 2015 General Election who did you vote for? *

Regardless of how likely you would be to actually vote, if a London MAYORAL election was held today, which party would receive your vote? *

Regardless of who you would vote for, how likely is it that you will turnout to cast your vote on May 5th 2016? *

By this we mean, how likely would you actually physically go to place your vote in the ballet box

Regardless of how likely you would be to actually vote, if a London GENERAL election was held today, which party would receive your vote? *

Regardless of how likely you would be to actually vote, if a Referendum on the UK's relationship with the EU was held today, would you vote for Britain to remain in the EU or would you vote for Britain to leave the EU? *

Ok, even if it is only slight, which way are you leaning towards?

Thinking again about your vote at the EU Referendum [NOMINATED AT Q7], how likely is it that you would change your mind and consider voting to REMAIN before the referendum?

SCREENING: Research Specific Criteria

Have you ruled out voting for any of the following political parties at the 2016 mayoral elections?

SCREENING: Suitability

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. *

Agree

Disagree