Signout

	Please Read: I understand that this focus group discussion is being audio and visually recorded and at the completion of the session, the recordings will become the property of the client sponsoring the discussion. With this understanding, I agree to participate in this focus group discussion.	Please Read: I have been compensated ________________ for participating in a focus group session held at Boulder Focus Center on _____ / _____ / _____.
 PRINT your Name 	 Sign In by your Name 	 Sign Out by your Name 
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________
_______________	_______________	_______________

Session Information

Date & Time:

Location:

Project Number:

/home/ec2-user/sec/disk/omb/icr/201102-3060-012/doc/22925801