Test Participant Sign-Up

Test Participant Sign-Up Form

By completing and submitting this form, you will be registering yourself as a potential candidate to use and evaluate various products from websites to laptop computers. To ensure that we have the appropriate participants for the products to be tested, it is essential that you complete all of the fields on this form and that your responses are accurate. Note that the terms of Usability Sciences' Privacy Policy prohibit children under the age of 14 from registering.

Please tell us about yourself: (* = Required Field)

Please select a button: *

This is my first time to enroll:

I am enrolled, and I am just updating my information:

Personal Information Salutation:
First Name: *
Last name: *
Primary Daytime Phone: *
Cell Phone:
Home Phone:
Home Street Address:
Home City: *
Home State/Province (ex: TX): *
Home Zip/Postal Code:
Home Country (ex: USA):
Email: *
(used for all communication)
Backup Email: *
(This will only be used if your primary email address is not functioning)
Gender: *
Marital Status?: *
Ethnicity: *
Place of Residence? *
Yearly Household Income (combined): *
Your Birth Year: *
No. Children at Home: *

(Children birthdates will only be used for statistical purposes. Please enter date in this format 01/01/1980)

Birthday Child #1:
Birthday Child #2:
Birthday Child #3:
Birthday Child #4:
How Did You Hear About Us?
Other (Please specify)

Computer Information Frequency of Internet Purchase:
Year Started Using Internet:
Types of Internet Purchases? Preferred Internet Browser:
Do you have a Home Computer?
(check box for "yes")

Do you have a Work Computer?
(check box for "yes")

Internet Service Provider at Home:
(ex:Verizon, America Online, etc)
Hours of Internet at Home per week:
Hours of Internet at Work per week:
Internet Speed - Home:
Internet Speed - Work:
Operating System Home:
(Use control button for multi selections)
Operating System Work:
(Use control button for multi selections)
What General Applications do you have experience with?
(Ex: MS Word, Ms Excel, QuickBooks)
What Graphic Design, HTML, Programming applications do you have experience with?
(Ex: Photoshop, Frontpage, C++)
What Networking Experience do you have?
(Windows, Server, Novell, etc)

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.

Level of Computer/Internet Experience: *

Work Information Company:
Title:
Company Industry:
Employment Status:
Num of Employees in Company:
Highest Level of Education:
Job Function:
Other:
Job Description:

Travel Information Have you Purchased Airline Tickets directly from an airline site?
(check box for yes):

Have you Purchased airline tickets thru an online service?
(Expedia, Travelocity, etc)

Where have you Purchased Airline Tickets online?
Approximate Num of Business Trips per Year?
Approximate Num of Leisure Trips per Year?

Technology Information

Do you:

Own a cell phone?
(Check box for "yes")

Own a PDA?
(ex: Pocket PC, Palm):

Own an MP3 device?
(ex: iPod):

Additional Information

Though our projects may occur in different cities around the world, the majority take place at our corporate headquarters in Dallas/Fort Worth, Tx.

Can you Test in Dallas (Las Colinas/Irving) area? *

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.)

Check box for "yes":

Thank you for answering these questions. By submitting your information, you will enter our database as a test member. You may receive frequent emails notifying you of upcoming tests that you might qualify for as well as updates concerning your participation.

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