Have you ever wanted a direct channel to share feedback with today's top companies, causes and organizations? Join The Bernett Group's Online Smart Panels and become part of a select group where you'll be able to make a difference and have your opinion heard.



* Necessary Field

Please select your interests below.*

 Travel Pets Politics Dining Out Social or Community Issues Beauty & Cosmetics Computers & New Technology Movies & Entertainment Beer & Wine Other



What is your first name?*



What is your last name?*



What is the best phone # contact you?*



What is the best email to contact you?*



What is your birth date? Please enter as MM/DD/YYYY*



What is your sex?*

 Male Female Other



What is your race or ethnicity?

 White or Caucasian Black or African American Native American or Alaskan Native Asian Native Hawaiian or Other Pacific Islander Other Prefer Not to Answer



Are you Spanish, Hispanic, or Latino?

 Yes No



What is your marital status?

 Married Single Living w/Partner Widowed Prefer Not to Answer



What is your employment status*



What is your job title?



Please choose the range that your household income falls into.



What is your highest level of education.



Do you own or rent your home?



What city do you live in?



What state do you live in?



What county do you live in?



What is your zip code?



How long have you lived at your current residence?



Are you a member of any other online panel, and if so, what panel(s) do you belong to?*



Do you have a Gmail account, & have you used Google Hangout?*

 Yes I have a Gmail Account, and have used Google Hangouts. Yes I have a Gmail Account, but I have never used Google Hangouts. No, I do not have a Gmail Account.