Participant Form PROJECT DETAILS: Online Focus Group – Shoppers – Food / Drink Specialty!DATE: Wednesday, October 18th, 2023TIME: Multiple Times Available DETAILS: Market Research Focus Group LOCATION: ONLINE – Must have a LAPTOP or DESKTOP computer to participate!Pay: $150.00! Register with us by filling out the form below.RM_StatsFirst Name *Last Name *Age *Gender Male Female Phone *Secondary PhoneEmail * City, State, ZIP City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region * Country * Zip * County / ParishEthnicitySelect an optionAmerican Indian or Alaska NativeAsian (ChineseJapaneseFilipinoKoreanVietnameseSamoan or other)Black or African AmericanEast IndianMiddle EasternHispanic or LatinoNative Hawaiian or Other Pacific IslanderWhiteHighest Level of EducationSelect an optionTrade CertSome HSSome CollegeProfessional CertNo HSHS GradProfessional DegreePost GradMaster'sDoctorateBachelor'sAssociateAll But DissertationCurrent Employment StatusSelect an optionEmployed full-timeEmployed part-timeSelf-EmployedActive MilitaryInactive military/VeteranTemporarily UnemployedTemporarily EmployedFull-time homemakerRetiredStudentDisabled Describe your job title and what type of company you work for:Do you or any family members work for the media Yes No How many research studies have you previously participated in?Select an option01-23-45-78-1010+Which Of These Quick Service Stores Have You Ordered FOOD or DRINKS from in the past month? * McDonalds Chick-fil-A Subway Circle K Stake & Shake Starbucks Dunkin Donuts Family Express Cefco 7-Eleven GetGo Speedway Wawa Other Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.