Request edit access
Melrose White focus group -- Men
***The number of slots for this group have filled- however, if you wish, you can still fill this form out to be placed on a wait list; if someone cancels their attendance, we will place the next registrant into that slot.***

Welcome to the sign up for the White Men focus group. Please fill this brief form out to register to participate in the focus group.  There are a limited number of slots for the group. Because of the limited amount of seating available, it is possible that the group has filled prior to our processing this registration. We will email you a confirmation of your registration.

If you have not done so, please feel free to fill out the Melrose online survey.
Sign in to Google to save your progress. Learn more
First and Last Name *
Email Address *
Phone
Race/Ethnicity (i.e., country of origin)
White Men focus group -- 1/24; 6;00pm *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of VISIONS, Inc..

Does this form look suspicious? Report