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Thank you for your interest in re-shaping the perception of Canadians 50+ by joining the 50plus Matters™ panel. We would love to understand a little more about you and your interests so that we may reach out to you with subsequent survey opportunities for free samples, coupons and/or contests. Please answer the questions below to complete your registration profile. All responses are confidential.

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1. First Name *This question is required.

2. Last Name *This question is required.

3. Email Address *This question is required.

4. Mailing Address

5. Suite

6. City

7. Province

8. Postal Code

9. Gender *This question is required.

10. Birthdate (mm/dd/yyyy) *This question is required. This question requires a valid date format of MM/DD/YYYY.

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11. What was your household income before taxes in the last 12 months? *This question is required.

12. What is your household's size (including any children and dependents still living with you)? *This question is required.

13. How many children (under the age of 18) live in your household? *This question is required.

14. What is your current employment status? *This question is required.

15. Our organization conducts surveys covering a broad range of topics.
Please let us know which topics you would like to receive surveys for further input. (Select all that apply) *This question is required.

Physical Exercise Habits
Health and Wellness
Lifestyle
Home & Garden

Media and Entertainment
Finance
Insurance
Retirement Planning

16. Our surveys offer a variety of rewards.
For future survey consideration, please let us know which of the following would interest you. (Select all that apply) *This question is required.

High Value Coupons
Contests
Free Product Samples

$5 Gift Cards
$10 Gift Cards