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Sign-up to Participate in
Consumer Research

By submitting your information below, you may be called to participate in consumer studies.  Participants are typically paid for their time.  The amount varies depending on the nature of the study and the time investment.  It is important that you complete the form in its entirety, as different studies require participants with a variety of profiles. Your information is kept confidential.  If you have already completed a Focus on Food data base form, please do not re-submit another form. Doing so will delete you entirely from our data base. If you have a change of information, please email your change to harriette@focusonfood.com and your file will be updated.

By entering into Focus On Food's database, I understand and agree to the following:

  1. I have voluntarily provided Focus On Food with personal data to be used during the research process. This information will not be shared with others for any purpose other than research.
  2. I will be honest and answer truthfully to the best of my ability.
  3. I will participate in the group discussion or interview by engaging in conversation or answering questions.
  4. I will arrive prior to the agreed appointment time or I understand that I may not be able to participate in the research.
  5. I understand that I may become ineligible to participate in a study if my answers or usages change prior to participating.

*Required Fields

 Participant Information

How did you learn about the Focus On Food participant opportunity?
   Other:

First Name*

Middle Name

Last Name*

Address1*

Date of Birth*

Address2

City
City will be determined
by Zip Code

State
GEORGIA

Zip*

At least One Valid Phone number is required.

Area*    Home Phone*
  
No Home phone

Area    Work Phone*
  
No work phone

Area    Cell Phone
  
No cell phone

Gender*

 

 

Email
(Your e-mail address is used as our first point of contact in many cases. It will be kept confidential along with your other information.)