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Jury Research Project Participant Questionnaire Form

Thank you for your interest in participating in the Jury Research Project. Please complete the questionnaire below to determine your eligibility. Questions marked with an * are mandatory. Please only complete and submit the questionnaire form once. Should you meet the requirements we will call you to confirm your participation.

"*" indicates required fields

First Name*

Middle Initial

Last Name*

Please upload a photo of your valid Driver's License or State ID:*

Accepted file types: jpg, gif, png, pdf, Max. file size: 8 MB.

Cell Phone Number*

Home Phone Number

Phone Number you can be reached at between 9am and 5pm*

Email Address*

Gender*

Male

Female

What is your age?*

Race*

White

Black

Native American

Hispanic

Asian

Other

Have you ever participated in a jury research project or served as a mock juror?*

Yes

Are you a U.S. Citizen?*

Yes

Are you registered to vote in your county?*

Yes

Political Affiliation*

Democrat

Republican

Independent

Other Party Affiliation

No Party Affiliation

How did you hear about the jury research project?*

Craigslist

Facebook

Other

Please specify how you heard about the jury research project:

What County are you a resident of?*

Have you lived in your county for at least a year?*

Yes

Do you have a current and valid State ID?*

Yes

Can you read, write and understand English without assistance?*

Yes

Have you been convicted of a Felony?*

Yes

Do you have access to a high speed internet connection?*

Yes

Do you have access to a laptop/desktop computer (Windows or MAC) with a camera and microphone (mic)?*

Yes

Do you have experience with Zoom meetings?*

Yes

What is your Occupation?*

What is your highest level of education?*

Some high school

High school graduate or GED

Technical or trade school

Some college courses

Associate (2-year) degree

Bachelor of Arts (4-year) degree

Bachelor of Science (4-year) degree

Some graduate study

Master’s degree

Doctoral degree

Professional degree

Marital Status*

Never Married

Married

Divorced

Separated

Widowed

Number of children?*

Do You Favor the Death Penalty?*

Yes

Total annual household income?*

Do you rent/own a home?*

Rent

Own

Neither

Have you ever been a party to a lawsuit, other than a divorce?*

Yes

Have you ever served on a jury or are currently on a jury or called for upcoming jury duty?*

Yes

Do you have any experience in the legal field?*

Yes

Name of the last book you read?*

What magazines do you like to read?*

What websites do you like to read?*

Do you read the newspaper? If so, which one?*

How many times a week do you read the news?*

How do you get your news and from where?*

What are your hobbies?*