Northeast & Central PA Community Focus Group Signup

The Institute & WVIA Public Media are seeking residents of Northeastern & Central Pennsylvania to engage in a 60 minute individual or small group interview on your community, local issues, and news media coverage. Your responses will be confidential and used for this research only. Participants selected for discussion who complete the interview will receive a $20 gas or grocery gift card.

Please complete the questions below and you may be contacted by a researcher from The Institute.

Completing the questions below does not guarantee you will be selected to be interviewed because only a limited number of people from each county will be invited to participate. For more information, contact Andrew Chew, Research Consultant, at chew@institutepa.org.

Question Title

* 1. Please provide your contact information below.

Full Name

ZIP/Postal Code

County

Email Address

Phone Number

Question Title

* 2. Which of the following days and times are best to reach you? Check all that apply.

Weekday earlier mornings - 8am to 10am

Weekday later mornings - 10am to Noon

Weekday early afternoons - 1pm to 3pm

Weekday later afternoons - 3pm to 5pm

Weekday evenings - 6pm to 8pm

Weekends

If you'd like to provide any more information about the best time to reach you, please provide it here.

Northeast & Central PA Community Focus Group Signup

Question Title

* 1. Please provide your contact information below.

Question Title

* 2. Which of the following days and times are best to reach you? Check all that apply.

Question Title

* 3. Optional: How did you hear about this opportunity?