Benchmark Panel - Registration Form
First Name *
Your answer
Last Name *
Your answer
Gender *
What year were you born? (please write in full eg 1976) *
Your answer
What month were you born (please select) *
Mobile or best contact number *
Mobile number is preferred as we usually contact you via sms.
Your answer
Email address *
Your answer
Which state do you live in? *
Who is the main grocery buyer in your household? *
Do you have any food allergies, intolerances or restrictions? *
Required
If 'Yes', please list the foods you avoid:
Your answer
Which of the following locations are convenient for you to attend Taste Tests? (tick all that apply) *
Required
How many years have you lived in Australia? *
Do you and/or your partner smoke? (tick all that apply) *
Required
Do you have any children living at home? *
What year was your 1st child born?
Your answer
What year was your 2nd child born?
Your answer
What year was your 3rd child born?
Your answer
What year was your 4th child born?
Your answer
What year was your 5th child born?
Your answer
How did you hear about our taste test panel?
Thank you for registering your details. Hit the submit button below, then LIKE our facebook page (Benchmark Taste Test Panel) to keep up to date with taste tests happening in your area.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.