Participant Registration Form.

Please fill out the form below and click on the "Submit" button when finished.


Survey Password:
(This password is contained in the email invitation you received to participate,)
Your Name
(First name and Last Name without a space)
For example: JohnDoe or MaryDoe
(This will be your user name)
A password (the last four digits of your social security or driver's license number):
(This will be your password)
Postal Address Street Address
 

City
State
Zipcode
County
Country
E-mail Address
Are you a US citizen? Yes No
Are you a registered voter? Yes No
Do you have a valid driving license? Yes No
Age
Regardless of age, are you willing to serve on a jury? Yes No
Gender Male Female
Your Occupation
Highest Level of Education
Combined familyincome
Are you...? Married
Single
A domestic partner
Please indicate how many children you have.
Do you have young children at home that you alone care for? Yes No
Do you have a mental or physical disability that would make it hard for you to serve on a jury? Yes No
Have you ever been summoned for jury duty, whether you were chosen or not? Yes No
Have you ever been convicted of a felony? Yes No
Ethnicity
Religion
Languages spoken and understood
What is your political party preference? Democratic Republican Independent Other
In general, what are your views? Conservative Moderate Liberal
Does your employer have a legal department or house counsel? Yes No Not Applicable
Do you have a personal or family lawyer? Yes No


Confidentiality Statement:

I pledge not to copy, reproduce or transmit any part of this survey

I AGREE