Focus Group Participation Form Question Title * 1. If selected for the focus group, I will do my best to provide honest opinions about what I am asked and arrive at an honest and fair decision. Agree Disagree Question Title * 2. If selected for the focus group, I give my permission to be videotaped during the session. Agree Disagree Question Title * 3. If selected for the focus group, I agree to sign a Confidentiality Agreement and not to disclose any facts I learn during the focus group. Agree Disagree Question Title * 4. Which city and neighborhood do you live in? Question Title * 5. Are you available for the Zoom focus group on Tuesday, August 25, 2026 from 6-8:30 p.m.? Yes No Question Title * 6. How old are you? Question Title * 7. What is your gender? (Required.) Female Male Other Prefer not to answer Question Title * 8. What is your race or ethnicity? Question Title * 9. What is your religious preference? Question Title * 10. Highest level of education COMPLETED? High School Graduate Associate's Degree Bachelor's Degree Master's or Doctorate Other (please specify) Prefer not to answer Question Title * 11. What is your current job status? Working full-time Working part-time Retired Unemployed Homemaker Full-time student Other (please specify) Prefer not to answer Question Title * 12. Are you a registered voter? Yes No Prefer not to answer Question Title * 13. What is your party affiliation? Question Title * 14. What is your role in your CURRENT job? Question Title * 15. What is your role in your PRIOR job? Question Title * 16. Contact Information Question Title * 17. CITY you live in Question Title * 18. COUNTY you live in Question Title * 19. Phone Number Question Title * 20. Email Address Done