Sign Up For Future Research Surveys Dear Reader, Redpen.com conducts periodic surveys and issues cash payments to Redpen.com members who respond. Because sound statistical practices require that we pull random samples from the entire Redpen.com survey panel, we can not predict when or if you may be asked to complete a survey. However, it is free to sign up and we do not release any personal information (email address, etc.) to any other companies. If you would like to be notified when future paid surveys are available, we invite you to become a Redpen.com panel member by completing the form below. Please complete all items. What is your email address? Your email address is never released to anyone and is only used to notify you when you may have a paid survey opportunity. Your first name: Your last name: What is your birthyear? SELECT 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 What is your birthmonth? SELECT JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC What is your gender? SELECT Female Male What is your marital status? SELECT Single Married Divorced What is your race? SELECT Asian Black (African descent) Caucasian (white) Hispanic/Latino Indian / South Asian Multiracial Native American Other Pacific Islander What country/region do you live in? SELECT United States Canada Mexico Britian Austrialia New Zealand Middle East Asia W. Europe (EU) E. Europe / Russia Central America (Guat. to Panama + Carribean) South America Africa What is your ZIP (Postal) Code? What is your educational level? SELECT No high school diploma High school graduate Some college / 2-year degree Bachelor's degree Master's degree / JD Doctoral degree / MD What is your current household income? SELECT Less than $10,000 $10,000-$20,000 $20,000-$35,000 $35,000-$50,000 $50,000-$75,000 $75,000-$100,000 $100,000-$150,000 $150,000-$200,000 Over$200,000 How many children live with you? SELECT 0 1 2 3 4 5 or more Which statement best describes your status? SELECT Employed full time Employed part time Full time student Unemployed Retired Who referred you to Redpen.com? Referrer's first name: Referrer's last name:   Copyright 2000-2007 Redpen.com. All rights reserved.