Participate In A Focus Group

Why participate?

It’s paid
Once you complete the focus group, you will be handed a check for $75.

Free dinner
Enjoy dinner – on us.

Kelly Supports phone number is an informational line only. All communication is via email. Businesses that we share office space with are unable to schedule you for a Focus Group.

First Name

Last Name

City/Town

Email Address

Phone Number

Company

Title

What gender do you identify as?

Male
Female
Prefer not to answer

What is your age?

18 – 30
30 – 40
40 – 50
50 – 60
60+

What is your ethnicity?

Caucasian
Hispanic or Latino
Black or African American
Native American or American Indian
Asian / Pacific Islander
Other
if “Other”, what ethnicity?

What is the highest degree or level of school you have completed?

No schooling completed
Nursery school to 8th grade
Some high school, no diploma
High school graduate, diploma or the equivalent (GED)
Some college credit, no degree
Trade/technical/vocational training
Associate degree
Bachelors degree
Masters degree
Professional degree
Doctorate degree

What is your marital status?

Single, never married
Married or domestic partnership
Widowed
Divorced
Separated

What is your political affiliation?

Democrat
Republican
Independent
Other

Check all that apply:

If employed, how long have you been at your current or most recent job?

Have you ever been party to a lawsuit?

Yes
No

Have you participated before?

Yes
No

Thank you for your interest in the focus group and filling out the application. We are looking for diverse demographics and once you submit the form, you will get an email when a spot opens for you.

By submitting this form, you affirm that you are not affiliated with an insurance company or another law firm.