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Name: *

E-Mail Address: *

Company: *

Phone: *

Choose any of the following cities for your upcoming project.

Plaza Research Markets: *

Paramus
Marlton
Atlanta
Dallas
Los Angeles
Chicago
Denver
San Francisco
Houston
Ft Lauderdale
Phoenix
Tampa
San Diego
Las Vegas

Dates of your project:

Type of Study:

Groups
IDI
Rental-only
Recruit-only
Rental & Recruiting
Product Placement
Telephone Interview
Taste Test
Kitchen Rental
Web/Online Survey

Topic:

Number of groups or interviews:

Number of recruits to seat per group (ex: X to seat X):

Length of groups or interviews:

Incentive Amount:

Will you be providing a client list to recruit from?:

Yes
No

Will we be able to identify the client during screening if recruiting from list?:

Yes
No

Special Services Requested:

Focus Vision
Active Group
Video Marker
Digital AV
Translator
Translation Equipment
Videographer

Please summarize the recruiting specifications for your upcoming project.

Have you worked with Plaza Research in the past?:

Yes
No

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