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Ohio Study

Ohio Study

First name

Last name

Email

Address

City

State

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What county do you live in?

Phone

Birthday * required

Occupation

What company do you work for?

Ethnic Background

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Income Level

When did you last participate in a group discussion or interview about a particular product or service?

What was the topic of your most recent research study you participated in?

Do you have a laptop or a desktop computer with a working webcam? * Required

Yes

No

Thanks for applying for our research project! We'll get back to you if we can use you for the study!

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