Alta Market Research

(Level 2, 40 Gloucester St., The Rocks, NSW, 2000)

Who are we ?
Our company has been in operation for over 23 years. We are a sub-committee member of the AMSRS (Australian Market & Social Research Society) and follow their defined standards, ethics and guidelines. We also adhere to the National Privacy Principles (Private Sector) Act 2000 as laid out in our Privacy Policy

What is Market Research ?
It is how companies gain feedback from the community about current or future products/services. Market research discussion groups may involve observation techniques, such as viewing or recording .

Our main areas of recruiting are for Focus Groups and Product Tests.
. Focus Groups : are run in an informal setting, they go for about 1.5 hours & people are paid cash for attending (normally somewhere between $50 and $80).
. Product Testing : usually involves viewing or trialling a product either at a central location or at home. Payment is via either a voucher or cash.

Next step:
If you would like to be added to our database, as available to attend Group Discussions/Product Testing, please fill out the questionnaire below. We will periodically email or phone you to see if you are suitable for current projects.

^* Please answer as many questions as possible, the more information you can give us the easier it is for us to match you to specific research project.
* We expect our respondents to answer all questions honestly and accurately. Those found to be doing otherwise will go on a 'Do Not Use' Register.
* Your information is treated with the utmost confidentiality and is held in a physically secure and access limited (via thumb-print & access card) environment. Your information will only be seen & used by us & only for market research purposes.

	This questionnaire should be filled out by any person over 18 years of age who is interested in attending MR discussions. - SYDNEY , BRISBANE & WOLLONGONG AREAs ONLY -

	Decided not to register? - please click here to tell us why:

1.	First Name :
2.	Surname :	Title:
	Add/Update Information ?
3.	Address :	(optional)
	Suburb:
	Postcode :	State : * Bris/Syd/Coast/Wollongong ONLY
		...
4.	Telephone - Home :
	Telephone - Work :
	Telephone - Mobile :	Plan:
		Mobile Provider:
5.	Email Address : [Please make 'susan@alta.com.au' an allowable address in your spam filter software]	* We may email you from time to time regarding groups, enter 'OPT OUT' in the Email Address if you do not wish this to happen.
	Email Check Frequency :
		...
6.	Your Gender :
	What is your Marital Status :
	What is your Nationality :	If born outside of Australia, enter year you arrived
	Date of Birth :	Day (01-31) / Month (01-12) / Year (1900-)
	Areas in which you would prefer to attend groups:
		...
7.	Job Title :	(10 characters max.)
	Employed Status :
	Self Employed :	No. of Employees:
	Which of these would best describe your occupation (ABS codes) :
	What Industry Type :
	Suburb in which you Work:
	What is your partners occupation (if applicable)	(10 characters max.)
		...
8.	Do you drink ? (mark whichever apply) :	Beer Wine NON-Drinker
		...
9.	Credit cards held (choose whichever apply) :

10.	What bank do you have your main account with :
	What type of account(s) do you have?	Savings Account Cheque Investment
	What Building Society do you have an account with :	(10 characters max.)
		...
11.	These questions relate to your main car(s):
	Car Make :
	Car Model :
	Year of Manufacturer :
	Main Car insured with :	(10 characters max.)
	Is this a company car :
	Are you a member of a car club:
		...
12.	Do you have pets (how many):	Cat Dog

13.	Do you have any children living at home, if so what is their year of birth (in YYYY format, ex. 1998):	Child BOY, year of birth : Child BOY, year of birth : Child BOY, year of birth : Child GIRL, year of birth : Child GIRL, year of birth : Child GIRL, year of birth : Are they interested in attending Groups ? :
		...
14.	Into which of the categories listed does the income of the entire household belong? (*ABS categories)
		...
15.	Do you smoke cigarettes :
	Do you wear spectacles/ contact lenses :
	Do you travel on business :
	Do you have Pay TV :
	Do you have Private Health Insurance with :
	How did you hear about us :
	Comments :



		Thank you

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