Register here to earn up to $175 per day from Bernett!

Bernett Research needs YOU to participate in our Mock Courtroom and Focus Groups. We will be willing to pay you up to $175 per day, just for your opinion. To learn more about Mock Courtrooms and Focus Groups, please click here

All of the information below is required, although some parts can be refused. Please be aware that refusing any information will decrease the likelihood of being included in any particular focus group. Thanks again and if you have any questions, feel free to contact us at register@bernett.com.

CONTACT INFORMATION:

First Name: Last Name:
Mailing Address:
Mailing Address Line 2:
City: State: Zip:
County:

Home Phone: () -
Home E-mail:

PERSONAL INFORMATION:

Gender:
Male Female

Birthdate (mm/dd/yyyy):
/ /

Including yourself, number
of people in your home:

Annual Household Income (Before Taxes):

Highest level of education you have completed:
Some high school or less
Graduated High School
Technical School
Some College
College Graduate
Post Graduate
Other:
Refused

Ethnicity:
Caucasian / White
African American / Black
Native American
Hispanic
Asian
Other:

Marital Status:
Married/Domestic Partnership
Divorced
Single
Separated
Widowed
Refused

Thank you for this information. We will register you for Bernett Research focus groups and call or email you when we have a group you may qualify for.

You can submit this information OR you can provide additional information which will increase your chances to be selected for specific groups. It takes about 5 minutes to enter your additional information.