Virtual Focus Group Questionnaire

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Seeking western Montana area and Wyoming residents for 2-hour, virtual focus groups. Ages 18+.
Compensation: $25/hour for 2 hours
Payment via PayPal

By filling out this form, you agree to be contacted via email for future opportunities. If selected, you will be notified via email.

What you'll be doing: We're looking for a diverse group of people to provide input on community issues.

REQUIREMENTS:
~Must have access to a laptop, desktop, or tablet with microphone and front-facing camera for the duration of the virtual focus group. Mobile phone use will not be allowed.
~Must commit to a stationary location for the duration of the virtual meeting.
~Confidentiality Agreement to be signed prior to virtual meeting.

*Sessions will be recorded. All information provided is CONFIDENTIAL and will be used only for focus group selection and research purposes. We will not share your information.

Email *

PayPal Email Address (if different than contact email)

How did you find us? *

I will have a working laptop, desktop, or tablet with keyboard, camera, microphone, and internet connection for the duration of this virtual focus group. *

Yes, I will use a laptop computer with camera, microphone, and internet

Yes, I will use a desktop computer with camera, microphone, and internet

Yes, I will use a tablet with keyboard, camera, microphone, and internet

Required

I am comfortable using and communicating via Zoom. *

Not comfortable at all

Extremely comfortable

Full Name (First, Last) *

Age *

Gender *

Female

Male

Prefer not to say

Other:

Race *

Address (Line 1) *

Address (Line 2 - City, State, Zip) *

Phone number *

Highest level of education completed *

Occupation *

Marital Status *

Single

Married

Divorced

Widowed

Required

Children (please list gender and ages)

Residence *

Own

Rent

Other:

Required

Combined annual household income *

less than $25,000

Between $25,000 and $50,000

Between $50,000 and $75,000

Between $75,000 and $100,000

Between $100,000 and $150,000

Between $150,000 and $200,000

More than $200,000

Required

Have you ever been involved in a law suit? *

Yes

If yes, please explain

Political Views *

Republican

Democrat

Independent

Conservative

Liberal

Other:

Required

Religious Affiliation *

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