Focus Group Contact Information
Paramount Focus Groups Application
First Name *
Your answer
Middle Initial
Your answer
Last Name *
Your answer
Suffix (i.e. Jr., Sr., III, etc)
Your answer
What is your Birth Date? *
You must be 18-years or older to participate. VERIFY YOUR Month, Day and YEAR!!!
MM
/
DD
/
YYYY
Are you Male or Female? *
Zip Code *
What is the Zip Code of your current residence?
Your answer
Political Affiliation *
Phone number *
Your answer
Email Address *
Your answer
What is your education level? *
How did you hear about us? *
Felony Notice
At Paramount Focus Groups our goal is to have our focus group members resemble actual juries in the jurisdictions in which the focus groups are conducted. On an actual jury if you have been convicted of a felony and your rights have not been restored, you would not be eligible to participate on the jury. By agreeing to these terms you agree that Paramount Focus Groups may at its sole discretion run a background check on you to confirm that you would be an eligible juror in the jurisdiction the focus group is being performed.
Do you or have you ever had a felony conviction? *
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