$125 "IN PERSON" WALNUT CREEK, CALIFORNIA RESIDENTS FOCUS GROUP
A credentialed child care provider will be available at the location. If needed, we will be providing child care while you will be in the discussion group.

Elite Market Reach Team is currently recruiting men and women to participate in a 2 hour focus group in Walnut Creek. If you are a custodial parent receiving child support or an absent parent paying child support we invite you to join this study and share your opinions on how satisfied or dissatisfied you are with the service. If interested answer the questions, submit them and call me at 419-754-1194 and ask for Chelsey.

Elite Market Research Team
Karen Bridgefourth, Team Leader
Chelsey Pritchett, Scheduler
419-754-1194

1. First Name *
Your answer
2. Last name *
Your answer
3. ZIP code
Your answer
4. Gender *
5. Are you currently receiving or paying child support through the California Department of Child Support Services or a county office? *
5A How long have you been receiving or paying child support through the California Department of Child Support Services or a county office? *
6. Please indicate which of the activities you do or have done working with any child support office in any state or county. *
Required
7. On a scale of 1 to 5 with 1 being “extremely dissatisfied” and 5 being “extremely satisfied,” how satisfied have you been with the California Department of Child Support Services or the county offices which have worked with you? *
Extremely dissatisfied Extremely satisfied (unhappy with)
Extremely satisfied (happy with
8. What is your age? *
Your answer
9. Which of the following best represents your ethnicity *
10. What is the language you mostly speak at home *
11. Thank you for your time. We would like to invite you to a 2-hour focus group discussion on October 19th at 3:00 PM (Females) & 5:15 PM (Males). As thanks for your time you will receive $125. If you qualify will you be available to participate? *
A credentialed child care provider will be available at the location. If needed, we will be providing child care while you will be in the discussion group. Do you anticipate needing child care during the focus group? *
IN WHAT CITY & STATE DO YOU LIVE? *
Your answer
PHONE NUMBER *
Your answer
EMAIL ADDRESS *
Your answer
HOW DID YOU HEAR ABOUT THE FOCUS GROUP? *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms