A Point Of View Research Services - Focus Group Sign Up Form

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A Point Of View Research Services
Your Partner in Market Research Success

Are you interested in participating in a focus group as a respondent?

A Point Of View Research Services conducts hundreds of focus groups per year. A focus group is an informal discussion lead by a professional moderator regarding a service, product or political topic. Focus groups usually last about 2 hours and are a lot of fun. We pay participants for sharing their views with us for our research. We never sell or promote any product or service.

We have a database from which we select participants for our focus groups. If you are not currently registered in our database and would like to participate in a focus group, please completely fill out and submit the form below. The information you provide will be kept confidential and will only be used to select qualified participants for upcoming market research sessions.

Focus Group Respondent Sign Up Form

Your Name:   Spouse Name:
Address:   City:   State:   Zip Code:
Home Phone #:   Office Phone #:
Your Cellular #:   Spouse Cellular #:
Your Email:   Spouse Email:
Your Date Of Birth:   Spouse Date Of Birth:
Your Occupation:   Spouse Occupation:
Your Auto: Year:   Make:   Model:
Spouse Auto: Year:   Make:   Model:
Motorcycle 1: Year:   Make:   Model:
Motorcycle 2: Year:   Make:   Model:
Jet Ski 1: Year:   Make:   Model:
Jet Ski 2: Year:   Make:   Model:
Children Living At Home: Child 1 Sex:   Child 1 Date Of Birth:
Children Living At Home: Child 2 Sex:   Child 2 Date Of Birth:
Children Living At Home: Child 3 Sex:   Child 3 Date Of Birth:
Children Living At Home: Child 4 Sex:   Child 4 Date Of Birth:
Household Income:   Residence:   Home Office:
Please check all items that you and your spouse participate in, consume or own:
Cat   Dog   Boat   Business Travel   International Travel   Credit Card   E-Commerce
Stocks   Online Trading   Movies   Wine   Imported Beer   Domestic Beer

Please click Submit Form when complete.

A Point Of View Research Services
Your Partner in Market Research Success

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