Project Flapjack Usability Test

Web-Based Screener
Thank you for your interest in participating in user experience studies at Fors Marsh Group. We are
currently seeking individuals that [targeted audience description]. For this study, participants will
interact with a website and provide feedback on their experience. One-on-one interviews will take
place at our [location placeholder text] from [start date] to [end date], and will be 60-minutes long.
Compensation ($75 in the form of a check) will be provided to those who participate.
Paperwork Reduction Act Statement [Link to new window].
[Paragraph below in the new window]
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor,
and a person is not required to respond to a collection of information unless it displays a
valid OMB control number. The OMB control number for this collection is 3170-0024. It
expires on 12/31/2015. The time required to complete this information collection is
estimated to average approximately 5 minutes per response, including the time for reviewing
any instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. Responding to this
collection of information is voluntary. Comments regarding this collection of information,
including the estimated response time, suggestions for improving the usefulness of the
information, or suggestions for reducing the burden to respond to this collection should be
submitted to Bureau at the Consumer Financial Protection Bureau (Attention: PRA Office),
1700 G Street NW, Washington, DC 20552, or by email to [email protected].

[Paragraph below included]
Privacy Act Statement
5 U.S.C. 552(a)(e)(3)

1

The information you provide through your responses to Fors Marsh will assist the study sponsor, the
Consumer Financial Protection Bureau (“CFPB”), in evaluating a prototype website that has financial
information.
The CFPB will not obtain or access any directly identifying information from Fors Marsh about study
participants. The agency will only obtain and access de-identified results and aggregated analyses of
those results.
Information collected on behalf of the Bureau by Fors Marsh will be treated in accordance with the
System of Records Notice (“SORN”), CFPB.021 – CFPB Consumer Education and Engagement
Records, 77 F.R. 60382. This information will not be disclosed as outlined in the Routine Uses for
the SORN. Direct identifying information will only be used by Fors Marsh to facilitate the study and
will be kept private except as required by law.
This collection of information is authorized by Pub. L. No. 111-203, Title X, Sections 1013 and 1022,
codified at 12 U.S.C. §§ 5493 and 5512.
Participation in this study is voluntary, you are not required to participate or share any identifying
information with Fors Marsh, including name and email address, and you may withdraw participation
at any time. However, if you do not include the requested information, you may not participate in the
study.
Thank you for your interest.
[The gray highlighted questions are standard FMG questions]
Q1.

First name: [Text box]

Last name: [Text box]

Q2.

Email [Text box]

Q3.

Mobile number: [Text box]

Q4.

Alternate number: [Text box]

Q5.

Date of birth: [Text box]

Q6.

What is your gender?
1. Male
2. Female

Q7. Are you Hispanic, Latino, or Spanish origin?
1. No, not of Hispanic, Latino, or Spanish origin
2. Yes, Hispanic, Latino, or Spanish origin

2

Q8. Please select all of the following that best describes your race:
1. White
2. Black or African American
3. American Indian or Alaska Native
4. Asian
5. Native Hawaiian or Other Pacific Islander
Q9. Please select all languages that you’re fluent (can speak, read, and write) in
1. English
2. Spanish
3. Chinese Mandarin
4. Japanese
5. Vietnamese
6. Korean
7. Taglog
8. Russian
9. Arabic
10. Haitian Creole
Q10.

What city and state do you live in? [Text box]

Q11.

Do you currently have or have you ever had or used a: (Select all that apply)
1.
2.
3.
4.
5.
6.

Q12.

Mortgage
Student loan
Credit card
Personal bank account/checking account
Money transfer service
Other personal loan

What best describes your current occupation? [Check boxes, select all that apply]
1. Going to high school
2. Going to community college, 2-year degree program, or trade school (either full-time or
part-time)
3. Going to a 4-year college/university (either full-time or part-time)
4. Working full-time
5. Working part-time
6. Homemaker
7. Retired
8. Not employed [Terminate]

3

Q13.

What is the highest educational degree that you have earned? [Radio buttons, select only
one]
1. Less than high school degree or equivalent
2. High school graduate (grade 12, diploma, or GED)
3. Trade school certificate
4. Some college courses completed
5. Graduated with a 2 year degree (Associates)
6. Graduated with a 4 year degree (Bachelors)
7. Some graduate school courses completed
8. Graduated with a post-graduate degree

Q14.

What industry do you work in? [Text box]

Q15.

What is your job title? [Text box]

Q16.

What devices do you usually use for work and personal use: [Select all that apply]
1. Desktop Mac
2. Desktop PC
3. Laptop Mac
4. Laptop PC
5. Tablet [what kind]
6. Mobile phone [what kind]

Q17.

What is your annual household income? [Radio buttons, select only one]
1. Less than $30K
2. $30K - $50K
3. $50K - $100K
4. $100 - $150K
5. More than $150K

[If eye tracking: instructions and Q18, Q19] This study includes eye tracking which will allow
researchers to see where participants look on the screen. We will ask you a couple of questions
related to this.
Q18.

Do you require glasses for reading? [Radio buttons, select only one]
1. Yes [Continue]
2. No [Skip to Q20]

Q19.

Can you wear contacts to the session rather than glasses? [Radio buttons, select only one]
1. Yes [Continue]
2. No [Terminate]

Q20.

How did you hear about research opportunities with us?
1. Google
4

2.
3.
4.
5.
6.
7.
8.
9.

Facebook
Washington Post online
Washington Post paper
Express newspaper
Craigslist.org
Restaurants or Cafes in Ballston (e.g., Starbucks, Panera, Buzz Bakery)
Friend or Family
Other [Text box]

Thank you for completing this survey. If you qualify for this study, a user experience team member
will contact you to schedule a time that is convenient for you. If you have any questions please
contact us at [email protected] or call us at 571-858-3817. You can also visit our website at
www.forsmarshgroup.com or our Facebook page www.facebook.com/ForsMarshGroup.

Phone-Based Screener (for those who qualify based on web-based screener)
Hello ______. Thank you for your interest in participating in user experience studies at Fors Marsh
Group. My name is ________ and I wanted to follow up regarding a web-based screener that you
completed recently for an upcoming study about a website. I wanted to ask a couple more questions
and see if we can schedule you. Your participation is completely voluntary. Do you have a few
minutes?
Q1.

Can you please verify your age?

Q2.

What is your current occupation?

Q3.

You had indicated in the questionnaire that you currently have, have had or used a [Insert
response from Q11]. Would you tell me a little about your experience with that financial
product or service?
[Open ended. Terminate if responses are inconsistent with web screener]

Invitation:
We would like to invite you to participate in our study. We will show you a financial website and ask
you to complete tasks using the website. The entire interview should last about an hour, and you will
be paid $75 in the form of a check when you are done. Would you be willing to participate in this
study?
Reconfirm participant’s email address.

5

Terminate message: both for web and phone screener
We are sorry but you do not qualify for this study. Would you like us to contact you for future studies
that you qualify for? [Radio buttons, select only one]
1. Yes
2. No

6