Description
On Wednesday November 17th, 2021 from 10:00am–12:30pm we will be holding a focus
group via Zoom. Payment will be $65 dollars for your time.
All backgrounds are encouraged to apply. More details will be emailed
to you if you are chosen. To apply, you must complete the following questions in full. We will
contact participants on Monday, November 15 to advise if chosen. Applications without complete
answers will not be considered.
Full Name:
Cell Phone:
Home Phone:
Number you can be reached at between 9am and 5pm:
Gender:
Age:
Race:
Political Affiliation (Democrat, Republican, or other):
E-Mail Address:
City you live in:
Marital Status:
Children?
Highest grade in school:
Place of Birth (city/state):
U.S. citizen?
Ever served in the armed forces of the U.S?
Current employer & how long employed?
Position or Title:
Self-employed?
If yes, name of company and type of business:
Location of employer (city/state):
Total family income? $0–$40K, $41K–$75K, $75K–$100K, $100K+
Do you own your own vehicle?
Make/model/year:
Do you rent/own home?
Ever been a party to a lawsuit, other than divorce?
If yes, what kind of lawsuit?
Ever served on a jury?
Name of the last book you read?
What magazines do you like to read?
How many times a week do you watch the news?
Read the newspaper? Which one?
Favorite movie genre?
Hobbies?
Discussion
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