Focus Group Screener Form

Focus Group Screener Form
Thank you for your interest in participating in user research at Local. This screener will determine whether or not you are eligible to participate in an upcoming study that we will be conducting in Local's office.
Thank you, User Research Team at Local.
Name
First NameLast Name
Phone Number
E-Mail
example@example.com
Do you or any member of your family work for a market research company?
Current Job Title
Name of the company you work for
Current Employment Status
Current Payment

What is the primary business or industry of your company?
Other (please specify)
Approximately how many employees are there, worldwide, at your company?
Approximately how long have you been employed by your current employer?
Approximately how many years have you been employed in your current profession?
Which of the following best describes you?
Should be Empty:

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