Great Lakes Marketing

3103 Executive Pkwy, Ste 106, Toledo, Ohio 43606

Phone: 419-534-4700

Fax: 419-531-8950

Opinion@GLM.com

 

 

 

 

JOIN OUR OPINION PANEL

YOU CAN SHARE YOUR OPINION AND GET PAID!

 

W

e at Great Lakes Marketing are interested in your opinion.  We gather information about products to help companies improve the goods and services they provide or develop new products that you want. 

 

 Your Name:

 Address:  

 City:               State:     Zip:

 Household/Evening Phone  (Very Important):   

 Daytime Phone:      Email (Very Important):

 Cell Phone:

 

Which best describes your annual household income?

 

  Under $30,000 per year

 $30,000 to $60,000 per year

     Over $60,000 per year
     

Which best describes the ethnic backgrounds in your household? (check all that apply)

 Caucasian

 

African American

 

  Hispanic

 

  Other:

 

Please fill in the table for every adult and child in your household.  Include yourself on the first line. 

Name

Date of  Birth

(M/D/Y)

Gender

(M/F)

Education    (Highest level completed)

Occupation

Full/Part Time

Marital Status

 

 

 

 

 

 

 

 

Please call 419-534-4700 for more information.

 

Thanks for your help; we hope to hear your opinion soon!