Focus Group Recruitment Questionnaire Survey

Example questionnaire to recruit online focus group panel members based on certian criteria like -- (Education, Work etc.)


I am with [MARKET_RESEARCH_COMPANY], a market research company based in [LOCATION]. We are conducting a survey about [SUBJECT] that might be of interest to you. We would like to include your opinions in this study. This is a marketing research study only, and we will not attempt to sell you anything at all today or in the future.

Thank you for your participation.

Do you or does any member of your household work for:
An advertising or public relations agency
A market research, strategic marketing or opinion company
The marketing or market research department of any company
A telemarketing firm
A food manufacturer or retailer
A software, hardware or multimedia company
Developer or manufacturer
Online retailer
E-commerce or web development company


Which of the following best describes your age?

Do you work full time or part time, outside the home?
Full-time [35+ Hours per week]
Part-time [15-20 Hours per week]
Full-time homemaker

Which of the following best describes the highest level of education completed?
Some High School
High School Graduate
Some College
Graduated College
Post Graduate

Family Status
Which of the following statements applies to you:
I have children under the age of 6 living at home
I have children between the ages of 6 and 17 living at home
I have no children under the age of 18 living at home

Online Services
a. Do you log on and use the Internet by yourself, without help, at either work or home?

b. How long have you been using the Internet, by yourself?
Less than 6 months
6 –-12 months
1 - 2 year
More than 2 years

c. How often do you use the Internet, not including email, by yourself, either at work or at home?
Less than one hour/week
1 –-2 hours/week
2-– 3 hours/week
More than 3 hours/week

d. On a scale of 1 to 5, with 1 being the least comfortable and 5 being the most comfortable, how comfortable and familiar are you using the Internet, including such things as links, site addresses, or search engines?
Least (1)
2 3 4 Most (5)

Computer Usage
When using the Internet, either at home or at work, which do you use more often?
IBM Compatible PC

Research Experience
Aside from political surveys, have you participated in any market research studies such as panel discussions, focus groups or surveys, in the last 12 months?
* Name
* Email Address

Thank You for completing the Questionnaire... Your honest responses are truly appreciated.

Please click on the Finish Survey button to complete this Survey.