15717 Small Business

Thanks for your interest in this study!

We are looking for men and women to participate in a paid focus group about Small Businesses. The group will last for two hours and it will take place on Wednesday, September 6th at a location in downtown Chicago. Group times are available at 12:00, 3:00 and 5:30 PM. Participants will be compensated with a Visa gift card for $350. Free parking is provided at the facility.

Please fill out the survey below. A recruiter will contact you with some follow-up questions if it appears that we can place you in the study.

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* 1. About You.

Name

Age

Daytime Phone Number

Email Address

Your residential zip code

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* 2. What is your gender?

Male

Female

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* 3. Which age group do you fall into?

Under 24

25-30

31-40

41-50

51-54

55-64

65 and older

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* 4. What do you consider to be your ethnic background?

African American

Asian

Caucasian

Hispanic

Other (please specify)