Test Particpant Sign-Up for Fort Collins

Fort Collins Test Participant Sign-Up

Please tell us about yourself: (* = Required Field) First Name: *
Last Name: *
Gender: *
Year Born: *
(Note: The terms of our policy prohibit children under the age of 18 from registering.)
Primary Daytime Phone: *
Home Phone:
Cell Phone:
Street Address:
City: *
State/Province: *
Zip:
Do you currently live in the Ft Collins area?
Email: *
(You will be contacted via email to participate in usability tests.)
Second Email: *
(This will only be used if your primary email address is not functioning)
Yearly Household Income:

Please tell us about your employer: Employment Status:
Company:
Job Description:
Job Function:

Do you, or anyone in your household, work for any of the following companies? (Check for Yes)

Apple

Brother

Canon

Encad

Epson

Hewlett Packard

IBM

Kodak

Lexmark

Minolta

Nikon

Panasonic

Ricoh

Sharp

Sony

Sun

Tektronix

Xerox

Do you have a Work Computer? Check for Yes

Do you currently work inadvertising or market research? Check for Yes

Please tell us about your experience with technology products: Home Computer? Check for Yes

Hours of Internet at Home per week:
Operating System at Home: (Use control bttn for multi selections)

Computer/Internet Experience

Please rate yourself using the following definitions that BEST describes your experience.

Beginner - I am fairly new to using computers and the Internet, so I request technical support from my friends, family, or a help service very often.

Intermediate - I am somewhat comfortable using my computer, including the Internet, and can solve some minor problems myself. However, I request help fairly often.

Advanced - I am comfortable using my computer and the Internet. I can solve some moderately complex problems without assistance, but occasionally need some help.

Expert - I consider myself to be a technology expert, and rarely need help with technology issues.

Computer Experience Level: *
Level of Internet Experience? *
Internet Browser:
Internet Speed - Home:
Do you currently own or frequently use a scanner? *
Do you currently own or frequently use a digital camera? *
Do you currently own a film camera? * How did you hear about us?

Do you know any novice or non-computer users in your area that might be interested in testing with us?
(We will contact you for their contact information when we have a study that calls for this type of user.)

Thank you for answering these questions.

Submitting this information will enter you into our database as a test member. You will receive emails notifying you of upcoming tests that you might possibly qualify for as well as other updates concerning your participation.

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