Ultra-Low Emission Zone (ULEZ)

SELECT ETHNIC ORIGINWhite BritishWhite otherBlack CaribbeanBlack AfricanBlack otherIndianPakistaniBangladeshiAsian otherChineseWhite & Black CaribbeanWhite & Black AfricanWhite & AsianOther

Have you ever taken part in a market research group discussion or depth interview on any subject?

YesNo

When was the last time you attended a group discussion/depth interview?

Less than 6 months agoMore than 6 months agoNever

How many times have you taken part in a market research group discussion/depth interview?

None1 to 34 to 6More than 6

What subjects have you been interviewed on before?

Do you or any of your friends/relatives, work or have ever worked in any of the following trades/professions or for any companies mentioned here?

Market ResearchMarketingJournalismAdvertisingPublic RelationsNone of these

Do you drive any of the following types of vehicle?

Petrol car with a registration 2005 to 2019Diesel car with a registration 2016 to 2019Pre-2005 petrol car or vanPre-2015 diesel car or vanPre-2007 motorbikeNone of above

What is your registration plate (this will only be used to check the age of the vehicle)?

Do you ever drive this vehicle...

Within the Congestion Charge Zone? (Central London)Within the North and South Circular? (Inner London)Outside the North and South Circular? (Outer London)Don’t know the zones/area None of above

Do you receive any form of NON-MEANS-TESTED disability benefit?

1. Yes – Disability Living Allowance (DLA)2. Yes – Personal Independence Payment (PIP)3. Yes – Attendance Allowance (AA)4. Yes – War Pensions Mobility Supplement (WPMS)5. Yes – Armed Forces Independence Payment (AFIP)6. Yes – Carer's Allowance7. Yes – Severe Disablement Allowance8. Yes – Industrial Injuries Disablement Benefit (IIDB)9. Yes – Constant Attendance Allowance (CAA)10. Child benefit11. Employment & support allowance12. Guardians allowance13. Adoption Pay14. Paternity or Maternity pay15. Shared Parental Pay16. No

What date and time would you like to be interviewed?

Alternative time in case first choice is not possible?