Protecting your privacy is important to us. All information submitted through this form is kept private.

For more information see our privacy policy.

focus group – a small discussion group used in the market research profession

If you have not previously done so, you may be interested in joining our focus group database (at no cost to you), with the possibility of being asked to participate in future paid focus groups. We're an independent market research firm, and are looking for people from all walks of life who enjoy sharing their opinions. As a token of our appreciation, we offer cash incentives to all focus group participants for their time.

By filling out the confidential and secure information form below, you will automatically be registered in our database and will become eligible for consideration with respect to future focus group projects.

NOTE: We are not telemarketers; we do not ever sell anything! Our studies are purely information gathering in nature. We are only interested in learning the opinions of people.

All of your registration form responses will be submitted through a secure, 256-bit encrypted connection to our database. We will not sell or otherwise distribute any information gathered from you.

Although we recruit focus group participants for clients across America, we cannot guarantee you'll be chosen for any particular study.

If you have previously signed up and wish to update your information, please use our update form.

Focus Group Participant Registration Form

Prefix:
First Name:
Last Name:
Suffix:
Home Mailing Address:
City:
State:
Zip:
Gender:
Email:
Day Phone:
--
Evening Phone:
--
Cell Phone:
--
Date of Birth:
Marital Status:
How many children under the age of 18 do you have living in your household?
How many of those children are between the ages of 13 and 18?
Education:
Employment:
Annual Income:
Ethnicity:
Are you registered to vote in the parish or county in which you reside?
With which political party do you most closely identify?
Do you have a computer (or smart phone) with internet access that you use?
What type of connection do you mostly use to access the Internet?
How did you hear about our focus group database?
Please choose the title that most closely matches yours.
What best describes the business or industry of your company?
How would you rate your skills using a standard computer keyboard and mouse?