Product Testing Sign Up First Name*Last Name*Street Address*City*State*Zip Code*Primary Phone Number*Email Address*How did you find out about GenSpan?*Friend/Family MemberSocial MediaOB/GYN, Birth Center, Chiropractor, otherHospitalBaby Store (i.e., Buy Buy Baby, etc.)Baby Expo (i.e. Baby Palooza, Prego Expo, etc.)Prenatal Yoga Class (i.e. Bldg7 Yoga, etc.)Other If referred by a friend, please fill in friend’s email addressWhat is your birth year?20112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965What best describes the area you live in?RuralUrbanSuburbanOtherWhat is your total household income range, before taxes?Under $25,000$25,000-$44,999$45,000-$69,999$70,000-$99,999$100,000-$149,999$150,000-$199,999$200,000+If you are pregnant, please list your baby’s due dateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 20252026If you have children, please list their birth datesJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 202520242023202220212020201920182017201620152014201320122011201020092008200720062005JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 202520242023202220212020201920182017201620152014201320122011201020092008200720062005JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 202520242023202220212020201920182017201620152014201320122011201020092008200720062005JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 202520242023202220212020201920182017201620152014201320122011201020092008200720062005Do you know anyone who works for a baby product company (Graco, Chicco, Evenflo, etc.)?*NoYesCommentsWelcome to the BE THE FIRST and SHAPE THE FUTURE product review programs. As part of these programs, you may receive occasional invites to participate in product reviews of baby gear. If you participate in a product review, you will either be paid for your time or get to keep the product for free! Signing up does not guarantee that you will be contacted to review products. All participation is optional. Check here if you’d also like to receive emails with other fun and friendly communications from GenSpan. (approx. 4/year)