Testpersonen Registrierung

Personal data

Address *
First Name *	Last Name *
Telephone *	Cellphone
Street	Street Number
ZIP Code	City *
State *	Place of employment *
E-mail address *	Date of birth (month/year) *
Marital status	Children
Youngest child's year of birth	Oldest child's year of birth
School education *
Occupation	Business
In which sector are you working?	Company size

Motor car possession

Motor car possession Yes No
Initial registration of motor car	Motor car brand
Motor car model	Motor car body
Type of vehicle (at point in time of purchase	Drive technology

Which of the following devices are used in your household?

PC Yes No	Source of supply of your PC
PC operating system
Notebook Yes No	iPad/Tablet PC
Notebook operating system
Digital camera Yes No	DVD recorder Yes No
Blu-ray player Yes No
TV	Game console
Cellphone Manufacturer	Cellular phone system provider
Cellphone contract	Mobile internet connection
Landline provider	Internet provider
Landline connection	Internet connection
Voice over IP Yes No	Voice over IP provider

Which of the following products do you consume on a regular basis or which brands do you prefer?

Beer	Wine
Regular brand of shower gel	Regular brand of antiperspirant

Other

Smoker Yes No	Cigarette brand
Pets	Pet food
Accomodation	Electricity supplier
Diabetic Yes No	Dominating hand
Experience in on-line communities Yes No	Do you have a homepage? Yes No
Last air trip	How many flights per year (approx.)
Were the flights…	What class?
Experience in market research Yes No	How did you find out about our services?
Message
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