Thank you

This form is to volunteer to be a subject of the Middletown USA Documentary as a possible subject in the Making a Home category.

If you have made your way to the Middletown USA website, facebook page or received a letter in the mail, thank you for taking this next step to agree to participate in this film project.

In addition for consideration to be a subject in this documentary film, your completion of this form puts you on the distribution list for upcoming focus groups and other location shoots.

Each month, I will conduct a focus group to gain information from the Middletown community about our town. Some information will guide other parts of the project -- like questions for interviews and further research -- and some will be included in video footage for the film.

When I have a focus group related to Making a Home, I will contact you through email to possibly be a participant.  In addition, if I am having a group interview or a location shoot related to the Making a Home category, I will email you.

Again, I thank you for your willingness to participate. Focus groups work best with a certain number of participants and not more. Should I receive more participant volunteers than is optimal for a good focus group session, I will inform you the day before the session and will perhaps invite you to attend another focus group.

Likewise, I hope I get more volunteers than I might have time to film.  If I don’t contact you to film you, please know that I still very much appreciate your support and interest in the project.

Nadine Owens Burton
Director, Writer, Producer


P.S.  After you click "Done" on the survey, it should bring you to the Middletown, USA website.

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* 1. I would like to participate in the Documentary under the Making a Home category.

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* 2. Please provide me with your name and contact information.

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* 3. I _____ (Please indicate all that apply)

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* 4. In what other documentary categories would you be willing to participate? (Click all that apply)

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* 5. Questions or Comments?

Thank you.

Nadine

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