*1.Full Name(Required.)

*2.Email Address(Required.)

*3.Phone Number(Required.)

*4.I am available from 1:00 to 3:30 pm, October 30, 2026 and am interested in participating in the Focus Group. I understand that I will need to participate via Zoom video from a quiet private location if I am selected to attend.(Required.)

Yes

*5.I understand that, before I am confirmed as a participant, I must (1) receive an email confirming that I am selected, (2) provide a copy of my photo ID, and (3) sign a confidentiality agreement.(Required.)

Yes

*6.By checking this box below, I confirm I am a resident of one of the following counties: Santa Clara, Santa Cruz, Monterey, or San Benito County. I understand that I MUST be a resident of one of these counties in order to participate in this focus group.(Required.)

Yes