Join the Club!

1. First Name:
2. Last Name:
3. Address:
4. Continued:
5. City/Town:
6. Province: -- Select a Province -- Alberta British Columbia Manitoba New Brunswick Newfoundland Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
7. Postal Code:
8. Phone Number:
9. Age group: -- Select a Age group -- under 24 25-34 35-49 50-64 65 or older
10. Email:
11. Are you…?:

    FemaleMale
12. Household Composition:

    Adult only (everyone 19 or older)
    Adult(s) plus any kids/teens (18 or younger)
13. In a typical 7 day week how many times do you eat beef at home or at a restaurant? -- Please Select -- 0 1 2 3 4 5 6 7 8 9 10
14. Who in your household is primarily responsible for the grocery shopping? -- Please Select -- Yourself alone Yourself and someone else equally Someone else alone
15. How did you hear about the Make it Beef Club?
    [multiple responses allowed]

    Beef recipe booklet
    Grocery store
    Magazine/newspaper ad
    Magazine/newspaper article
    Beefinfo.org website
    Other website/link
    Family/friend
    Other
    Don't recall
16. Are you willing to be contacted to participate
    in consumer research (online or telephone)?

    Yes, you may contact me for beef related consumer research
    No, please do not contact me for beef related consumer research

* Press the "Submit" button only once. Your registration
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