Topical Issues in the Media and You!

<p>Would you like to share your thoughts on <strong> topical issues </strong><strong>and current affairs</strong> that may impact you and your family?</p> <p>This project will give you the chance to give honest feedback on a wide range of local issues and let us know what you feel is important!</p> <p>The research is in the form of a <strong>2 hour group discussion</strong> taking place on <strong>Tuesday 19th OR Wednesday 20th April</strong> </p> <p>To thank you for your time you will receive a <strong>£50 cash incentive</strong></p> <p><strong>Details as follows:</strong></p> <p><strong>Date</strong> – Tuesday 19th OR Wednesday 20th April<br> <strong>Times</strong> - 6pm or 8pm<br> <strong>Duration</strong> – 2 hours<br> <strong>Location</strong> - London<br> <strong>Incentive</strong> - £50 cash incentive<br> <strong>Type of research</strong> - Group Discussion</p> <p>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. </p> <p>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.</p>

Your Contact 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...

Which department(s) do you work within;

You and your Transport...

Do you own/use a car? *

You and Your Car...

Your Contact Information...

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.

SCREENING: Current & Past Employment

SCREENING: Past Research

Your Voting Preferences...

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

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. *

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