Thank you for completing this brief survey to indicate your interest in our upcoming college focus groups in Upstate New York later this June. This information is for research and screening purposes only and will be kept confidential. It will not be shared, and you will not receive marketing offers as a result of completing this questionnaire. Participants will receive a $100 gift card upon completion of the group.

If you have any problems with this survey, please contact

Question Title

* Please provide contact information so we know how to get in touch with you:

Thank you very much.  We will be in touch with you with details about the groups and to let you know if you qualify for one of them.  Thanks for your interest!