Consumer Focus Group Pre-survey

Thanks for your interest in this study!

MFORCE Research is looking for men and women to participate in a paid consumer focus group. The 75-minute groups will be held on Mon, Sep 24th or Wed, Sep 26th at a facility in downtown Chicago. Groups times are available as early as 1:00 PM and as late as 6:15 PM. The facility is located near the corner of Michigan & Wacker and free parking is provided on-site. Participants will receive $100 cash.

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

Question Title

* 1. About You.

Name

Age

Daytime Phone Number

Email Address

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* 2. What is your gender?

Male

Female

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* 3. Do you or does anyone in your family work for any of the following companies or industries?

Advertising agency or department of a company

Public Relations firm

Market Research firm or department

Marketing firm or department

A media company such as radio, newspaper, television

A bar, nightclub or restaurant (not including fast food)

A beer, wine or alcohol manufacturer, wholesaler, distributor

None of the above

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* 4. Which of the following best describes your current employment status?

Full-time, that is 30 hours or more hours per week

Part-time, that is less than 30 hours per week

Do not work at all outside the home