Focus Group Registration - Group Dynamics in Focus

Your opinions are needed!

Group Dynamics invites you to share your opinions and ideas about products and services.
It is easy to participate...

Just fill out our short questionnaire that tells us about yourself and your interests. This will register you in our database or update your record if you have participated in the past. We follow the practices endorsed by the National Marketing Research Association (MRA) and the Council for Marketing and Opinion Research (CMOR).

Anyone living in Philadelphia, Surrounding Counties or South Jersey can participate. We invite people of any age and all walks of life to give their opinions in a relaxed and comfortable setting.

Why participate?

Your responses are confidential and necessary to clients for improving their products and services or creating new ones - AND you are paid for your time.
Please view our privacy policy.

We will contact you by telephone when we have a project for which you may qualify. You are never obligated to attend, but if you accept our invitation, we take this as a commitment.

Please fill out the form below to Register. * Required Field

Contact Information

* First and Last Name:

* Address:

Apt./Floor/Suite:

* City:

* State:

* Zip Code:

* Phone (xxx-xxx-xxxx):

Cell Phone (xxx-xxx-xxxx):

* Email Address:

Personal Information

* Gender:

Male Female

* Race/Ethnic Background:

* Date of Birth (MM/DD/YYYY):

* Highest Level of Education:

*Current Job Status:

* Marital Status:

Spouse/Partner Job Status:

Spouse/Partner Occupation:

Spouse/Partner Employer:

Spouse School Attending:

* Child/Children Under 18:

Yes No

* Child’s/Children’s Gender(s):

* Child’s/Children’s Age(s):

Pets:

Yes No

* Smoker:

Yes No

* Household Income (Pretax):

Medical Information

Chronic Medical Conditions:
(Leave blank if none)

Additional Information

* How did you hear about us?: