Request a Focus Group Step 1 of 5 20% Firm Name*Firm Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Attorney Name* First Last Attorney Email* Attorney Phone*Paralegal / Assistant Name First Last Paralegal / Assistant Email Case Name*Trial / Mediation Date Date Format: MM slash DD slash YYYY Date(s) you wish to conduct the focus group(s)*Number of jurors you wish to present to* Juror DemographicsGender* Male Female Mix of both male and female This demographic is not imperative to my case Comments on GenderAge Range (Select all that apply)* 18-30 31-45 46-59 60+ This demographic is not imperative to my case Comments on Age RangeEducation (Select all that apply):* Some high school/high school diploma/GED Vocational/technical school/some college College degree/graduate degree This demographic is not imperative to my case Comments on EducationMarital Status (Select all that apply)* Single/never married Married/living with significant other Separated/divorced Widowed This demographic is not imperative to my case Comments on Marital StatusEthnic Background (Select all that apply)* White/Caucasian Hispanic African American Asian American Native American Other This demographic is not imperative to my case Comments on Ethnic BackgroundAnnual Household Income (Select all that apply)* Less than $25,000 25,000 to 39,999 40,000 to 54,999 55,000 to 69,000 70,000 to 84,999 85,000 to 99,999 Greater than 100,000 This demographic is not imperative to my case Comments on Household IncomePolitical Stance* Liberal Conservative Middle of the road Mix of all political stances This demographic is not imperative to my case Comments on Political Stance Will you be utilizing an outside focus group consultant to present your case?*YesNoIf yes, please provide the consultant’s name and contact information.Consultant Name First Last Consultant Email Consultant Phone Would you like to utilize one of our 60-inch SmartBoards to present evidence to your jury? (PowerPoint presentations, videos, remote witness testimony via videoconference)*YesNoWould you like ARV to assist with printing of hard-copy evidence packets and/or jury questionnaires to have available for each juror?*YesNoIf yes, please provide the primary point of contact for coordination of hard-copy evidence/questionnaires (attorney, paralegal, legal assistant, etc.)Contact Name First Last Contact Email Contact PhoneAdditional Comments/Requests
