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* 1. Contact Information

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* 2. What is your gender?

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* 3. Date of Birth

Date

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* 4. I am:

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* 5. I live:

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* 6. What is your ethnicity? (Please select all that apply.)

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* 7. Are you employed?

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* 8. Please list your current position.

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* 9. If unemployed or retired, please list most recent position.

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* 11. Do you have children?

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* 12. Are you a registered voter?

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* 13. Political party affiliation

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* 14. What is the last presidential election you voted in?

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* 15. With regard to jury service, I...

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* 16. Other than a divorce, have you ever been a party to a lawsuit?

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* 17. Are you contemplating bringing any lawsuit in the next year?

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* 18. Have you ever worked for a company that manufactures and/or distributes hair relaxing products?

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* 19. Have any of your family members ever worked for a company that manufactures and/or distributes hair relaxing products?

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* 20. Have you ever used hair relaxers to relax your hair at home, at a salon or both?

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* 21. If you have used hair relaxers in the past, please list which products you have used.

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* 22. I have social media accounts on:

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* 23. Whether television or internet, what national news organization are you likely to get your news from?

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* 24. I have lost friends or family because of my political beliefs:

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* 25. What is your favorite movie genre?

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* 26. Have you ever donated your time, money or items to charity?

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* 27. If selected to participate in this focus group, my preferred session is:

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