Focus Room Database Signup
Please fill out the short survey below to join our database and to be notified for upcoming paid focus group opportunities.

Your privacy is extremely important to us.
Any information you provide will be used for research purposes only.

The Focus Room privacy policy can be found here:
https://focusroom.com/img/The-Focus-Room-Database-Privacy-Policy-2018-05.pdf 
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First name *
Last name *
Email address *
Phone number *
If employed, what is your Job Title? *
How old are you? *
What year were you born?
What City do you live in? *
What state do you live in? *
What is your race? *
What is your gender identity? *
What is your household income? *
What is your employment status? *
What is the highest level of education you have completed? *
What is your relationship status? *
How many children are you parent or guardian for and live in your household (aged 17 or younger only)? *
必填
What is your zipcode? *
What is the brand and model of your current smartphone? *
If employed, what industry do you work in? *
Which of the following best describes you? *
Have you received the COVID-19 Vaccine? *
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