| 
                                                                                                                 Current Work Status                                                                * | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Employment Type (if applicable)                                                                  | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Occupation - Type                                                                  | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Occupation - Industry                                                                  | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Personal annual income                                                                * | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Household annual income                                                                * | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Main Bank                                                                  | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Housing Status                                                                * | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                 Marital Status                                                                * | 
				
					                                   
							                                   
							                                   
							                                   
							                                   
											 | 
			
						
                         
				| 
                                                                                                                 Work Postcode                                                                  | 
				
					                                                
										 | 
			
						
                         
				| 
                                                                                                                 How did you hear about us?                                                                * | 
				
					                                                         
						 
										 | 
			
						
                         
				| 
                                                                                                                     
                                                                    If a friend referred you to our website for registration, please insert their name here (they could win a prize for your referral)                                                                        
                                                                  | 
				
					                                                
										 | 
			
						
                         
				| 
                                                                                                                     
                                                                    Do you complete over 60% of the grocery buying for your household?                                                                        
                                                                * | 
				
					                                   
							                                   
											 | 
			
						
                         
				| 
                                                                                                                     
                                                                    How often would you visit A KFC, McDonalds, Red Rooster, or Subway outlet and purchase something for yourself?                                                                        
                                                                  | 
				
					                                   
							                                   
							                                   
							                                   
							                                   
							                                   
											 | 
			
			 
			
				|   | 
				
					 
					
					 
				 | 
			
			
				|   | 
				
					 
					
					 * = Mandatory Fields
					
				 |