KB Research - Registration form
Please note the * denotes that the field is mandatory

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Registration *
Gender *
Required
Surname *
First_Name *
Home_Phone *
What is your home phone number or mobile number
Work_Phone
Mobile_Phone
What is your mobile number - if not above
Internet_address *
What is your EMAIL
Enrolment_Age *
state *
Suburb *
What suburb do you live in
Location *
What Direction are you living in relation to your states CBD eg Melbourne, Sydney. NOTE: If you are not sure use this site - https://www.bing.com/maps/
dist_from_cbd *
How far do you live from you state capital city eg Melbourne, Sydney etc- In KMS
Marital_ Status *
ChildrensAge
How old are your children - even if you have adult children
Housing *
What best describes you housing arrangements. NOTE: Select home if you are living with your parents, and Buying if you have a mortgage.
Socio-Economic
What best decribes you type of work - Prof - Doctor, Lawyer, Engineer etc, SProf - Teacher, Nurse etc, Manager, Clerical, Retail, Trade - Tradesman, Manual - manual work ie factory hand, labourer etc,
Clear selection
Employment_ Status *
What best describes you employment status - if a full time student put that down even if working part time
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