Focus Group Registration


 

Alan Newman Research and Richmond Focus Group Center conduct hundreds of focus groups per year. A focus group is an informal, round-table discussion lead by a professional moderator. Most often, the discussion is in regard to a service, a particular product, or advertising. It was in focus groups that ideas like the automatic shut-off iron, bottled spaghetti sauce, and plastic shampoo bottles were conceived. We never sell or promote any products or services. In fact, we usually pay participants for sharing their views with us. Participants usually receive a cash payment as a token of our appreciation for helping with our research effort. Focus groups generally last about 2 hours and are a lot of fun. We have a database of about 10,000 people from which we select participants for our groups. If you would like to be included in our database so that your opinions can be heard in future sessions, please fill out and submit the form below. Your responses will be kept confidential and will only be used to select qualified participants for upcoming sessions.

Note: The following registration is for Virginia residents only.

Prefix

First Name
   
Last Name
 
Address
   
City/County
   
State
Zip Code
   
Home Phone
Work Phone
   
Email Address
   
Date of Birth
 (mm-dd-yyyy)
   
Marital Status
   
Level of Education
   
Race
   
Employment Status
   
Occupation
   
Income Level
   
Do You?
  
   
Have health insurance that is provided by
your employer
   
What type of insurance plan
   
What company provides your health coverage
   
Have any children under age 17
   
If so please list child's date of birth and age.
  
   
Child 1 age
 date of birth (mm-dd-yyyy)
   
Child 2 age
 date of birth (mm-dd-yyyy)
   
Child 3 age
 date of birth (mm-dd-yyyy)
   
Child 4 age
 date of birth (mm-dd-yyyy)
   
 
Play the lottery
   
Own a cellular phone
   
Have cable or satellite TV
   
Have a computer at home
   
Have Internet access at home
   
Do you have a digital camera
   
Do you have investments, such as stocks,
bonds, mutual funds
   
Do you have any subscriptions
   
What company provides you with the following:
  
   
Electricity
   
Gas
   
Long Distance
   
Local Phone Service
   
What is your primary bank
   
Do you consider yourself a Democrat, Republican or Independent
   
Do you own or rent your home
   
What are your hobbies or
special interests
 



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