Echo Talk - Echo Research Group

Would You Like To Be In A Focus Group?

Every month Echo Research Group conducts numerous focus groups on a wide variety of subjects at our Emeryville facility. We would love for you to participate and share your unique opinions with our clients and us. As a participant you will be compensated either in cash or in products, depending on the nature of the group.

Please take a moment and fill out and submit this form. We will call you when we feel that we have a project that you would be interested in and let you know how, when and where you can participate.

The information you provide us below is used only to give you an opportunity to participate in one of our focus groups. We will protect your privacy at all times and will not sell your name or release any of your information to any other person or company.
  1. Did someone refer you to Echo Research Group?
    If yes, who (name)?
  2. How did you hear about Echo Research Group?
    If other,
  3. Name:
    First

    Last
  4. E-mail Address:
  5. Daytime Phone:
  6. Evening Phone:
  7. Street Address:
  8. City:
  9. State:
  10. Zip:
  11. Date of Birth:
    (ex: 1973)
  12. Gender:

  13. Ethnicity:
    If other,
  14. Individual Annual Income:
  15. Household Annual Income:
  16. Martial Status:
  17. Number of Children:
  18. Ages of Children:
  19. Amount of Education you have completed:
  20. Do you Own or Rent?
  21. Pets:
    If other,
  22. Number of Televisions in your household?
  23. Do you have Cable or Satellite?
  24. Do you have a computer at home?
  25. Employment:
    If other,
  26. Title?
  27. Type of occupation?
  28. Name of Company:
  29. Work Dress Environment?
  30. Do you have Internet access at home?
  31. Do You have Internet access at work?
  32. Do you have a home office?
  33. Do you own a cell phone?
  34. Do you own a laptop computer?
  35. Subscriptions:
    Newspaper
    Magazines
    Electronics
    Other
  36. Do you shop online?
  37. Do you shop via catalogues?
  38. Beverages consumed (check all that apply):
    Coffee
    Soda
    Beer
    Milk
    Tea
    Wine
    Hard Liquor
    Bottled Water
  39. Musical Preferences:
    Alternative
    Jazz
    World
    Hip Hop
    Country
    Rock
    Other
    No Preference
  40. Recreational Activities (check all that apply):
    Backpacking
    Biking
    Camping
    Cooking
    Exercising
    Sports
    Gardening
    Hiking
    Yoga
    Skiing/Snowboarding
    Swimming
    Concerts
    Cultural Events
    Travel
    Other
  41. Special Eating Habits:
    Prefer Organic
    Enjoy Fast Food
    Diabetic
    Vegetarian
    Vegan
    Mostly Fish
    No Red Meat
    Lactose Intolerant
    Everything’s okay
    No Pork Products
    Other
  42. Do you frequently eat at upscale restaurants?
  43. Do you frequently eat at neighborhood restaurants?
  44. Do you purchase specialty coffee?
  45. Where do you do most of you grocery shopping?
    Supermarkets
    Trader Joe’s
    Whole Foods
    Costco
    Farmers Markets
    Other