Employment Focus Group

Participant Form

DATE: 08/22/2023 or 08/24/2023

TIME: 90min Sessions ONLINE

REQUIREMENTS: This project will take place over ZOOM Meetings – You Must Have Laptop / Desktop Computer To Participate. Must reside in East Dallas / Duncanville

First Name^*

Last Name^*

Age^*

Gender

Male
Female

Phone^*

Secondary Phone

Email^*

City, State

City

State or Region

Zip Code where you Reside (as stated on Drivers License)^*

Ethnicity

Highest Level of Education

Current Employment Status

Describe your job title and what type of company you work for:^*

How Long Have You Been Employed at Current Job?^*

What is Your Work Location?^*

Do you Interact with Customers on a Daily Basis?^*

Do you Speak Spanish?^*

Do you Have A Computer or Laptop with a Webcam and High-speed Internet?^*

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The information provided within this form serves the sole purpose of enrolling you in the designated research project. We assure you that your information will not be sold or shared with any third party entities.

Participant Form

Employment Focus Group

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