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HorizonPoll - Listening to New Zealand

Kia ora! Welcome to the HorizonPoll Maori Panel!

When you complete this Registration form and join the Horizon Research Maori Panel, you can do your first survey on the COVID-19 threat straight away.


Now your voice, experiences and needs can be heard...


By signing up right now you are in our next quarterly draw for $1000 cash and the latest iPad Pro (more powerful than most laptops) worth $1200! Or you can take the lot in cash: $2100!


In addition you get another entry in the draw for EVERY survey you complete!


PLEASE NOTE - We'd like you to complete as many of the information requests below as possible. This information is kept completely private and used for research purposes only. We don't share your details with anyone else.


Join HorizonResearch Maori Panel

First Name
Surname
Gender
(please specify your gender)
Your title eg: Prof, Dr, Mr, Mrs, Ms, Other
Your e-mail address
When we e-mail you, how would you like us to address you?
Date of birth
Which ethnic group or groups do you belong to?
Please select all that apply








Other (Please specify):
To which Iwi do you belong?
Which best describes your household's annual income before tax?
Which best describes your annual personal income before tax?
Are you in paid employment?
Which of the following best describes your occupation?

Other (Please specify)
What is the main activity of the business or employer you work for?

Other (Please specify)
Which of the following best describes your highest educational qualification?

Other (Please specify)
Which of the following best describes your household?

Other (Please specify)
Which of the following best describes your involvement in making decisions on behalf of your household? (optional)
During the last 12 months, have you personally participated in any decision on behalf of your employer or company to purchase goods or services to the value of...? (optional)
Your telephone numbers (one required)

We would like at least one telephone number to verify your registration and to contact you if you win prizes! All information is confidential.

Mobile Phone:
Best number - Day:  
Best number - Evening:  
Fax:
Local Government Area
Suburb (for Auckland Region Only)
Post Code (optional)
Parliamentary Electorate
Who did you vote for in the 2020 general election? (Party vote)
Who did you vote for in the 2017 general election? (Party vote)
Who did you vote for in the 2014 general election? (Party vote)
Who did you vote for in the 2011 general election? (Party vote)
Who did you vote for in the 2008 general election? (Party vote)
Enter a password to allow you to log in and update your details (or keep this password that has been randomly generated)
What is the sum of the following two numbers:
This ensures a person, not an automated program, is registering.
3 + 2 =


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