Thank you for expressing interest in joining our database!

Please be careful to answer all questions - leaving anything unanswered could leave out essential information in selecting participants for specific projects. Your information is securely transferred to our systems and personally identifiable information is never shared with anyone else. Your voluntary participation in Market research with Fieldwork constitutes an Independent Contractor relationship, not an Employment relationship.

If at any time you wish to unsubscribe from our database, you may call the office you signed up with or fill out this unsubscribe form.

(Fields marked with an asterisk "*" are required)
 

First Name:

*

Last Name:

*

Primary Phone: 

1---*

Cell Phone (If different than above): 

1---

May we call you at work?

Email Address:

*

Home Address:

*

City:

*

State:

*

Zip:

*

County:

Date of Birth: 

    *

Race:

Gender:

Marital Status:

Employment status:

Occupation:

Total household income:

Number of children under 18 living at home:

How did you hear about us?

Promo Code:


Much of our research is conducted based on extended demographics that we collect on all respondents. Completing an additional section will greatly increase the chances of you being pulled up in our database for an upcoming project.

Would you like to enter extended demographics


What are my responsibilities as a focus group participant?

Fieldwork and its clients rely on the integrity of focus group respondents to conduct accurate and meaningful research.

We ask that you commit to the following:

  • Providing your personal information to Fieldwork constitutes your express written consent for collection, storing and processing your personal information.
  • Be truthful in answering questions about yourself and your habits.
  • Arrive for your appointment at least 15 minutes early and be ready to fully participate in the discussion.
  • Understand that anyone arriving late for their appointment may not be admitted into the study or be compensated.
  • Notify fieldwork if you must cancel with as much advance notice as possible. Both fieldwork and our clients are depending on your participation, and while we understand that circumstances may come up forcing you to cancel, with advance notice, we have the opportunity to try to recruit another interested participant.
  • Enjoy & contribute to the discussion! Focus Groups are fun and your opinions count!
Panelists under the age of 18 must have a Parent or Guardian's permission to participate.

*  I have read and understand my responsibilities as a participant and I agree to the terms and conditions above.