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* 1. Please tell us about your availability.

  Best availability Sometimes available Not available
Weekdays
Evenings
Weekends

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* 2. Are there specific days/evenings when you are not available? If yes, please specify.

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* 3. How far are you willing to travel for a focus group (distance and/or time)?

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* 4. Please provide current contact information below. (Note: we use your address to factor in travel time to a focus group before we ask you to facilitate.)

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* 5. Anything else we should know about your availability?

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