focus group submission form
18-25 years old - male and female

Do you want your opinion heard?  We want to hear it!  CUPS is going to conduct it's first focus group on July 14th.  If you are interested in being a part of this or future focus groups, please complete the form below and submit.  Coffee and dessert will be provided.

 

Someone will be in contact with you if you are selected to a part of this or future focus groups.

Name *
E-mail Address *
Age *
Home Phone and Alternative Phone *
School Attending for the 2006-2007 School Year *

* Fields marked with an asterisk are required fields

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