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Join One of Our Focus Groups
Frequently Asked Questions

Home
Join One of Our Focus Groups
Frequently Asked Questions

Join One of Our Focus Groups

Name *

First

Last

Email *

What is your age?

Under 18
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65-74 years old
75 or older

What is your zip code? *

With which gender identity do you most identify?

Male
Female
Non-binary
Unsure/questioning
Prefer not to answer

How would you describe yourself? Please check all that apply.

American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latinx, or of Spanish origin
Native Hawaiian or Other Pacific Islander
White
Other

Please state your occupation.

What is your household income?

Fewer than $20,000
$20,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or greater

I agree to wear a face mask or protective face covering during the focus group if chosen to participate. *

I agree.

Comment

Note: By submitting this form, you agree to allow in∙focus∙groups to contact you via phone or email to schedule your participation in an Indiana focus group. You understand that submitting this form does not guarantee that you will be chosen as a focus group participant.

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