Screener

WBA Research

October 2015

BUSINESS FOCUS GROUPS

RECRUITMENT QUESTIONNAIRE

RESPONDENT'S NAME:__________________________________________________

COMPANY NAME:_____________________________________________________________

ADDRESS:_____________________________________________________________

CITY:_____________________________ STATE:____________ ZIP:_____________

TELEPHONE NUMBER: ( )_____________________________________________

DATE OF GROUP:__________________TIME OF GROUP: (Circle one) 6pm/8pm

INTERVIEWER:________________________ DATE RECRUITED:________________

(ASK TO SPEAK TO THE NAMED PERSON ON LIST, WHO IS RESPONSIBLE FOR COMPLETING BUSINESS INFORMATION SURVEYS REQUIRED BY THE FEDERAL GOVERNMENT.)

(READ:) Hello, my name is ________________from ________________,. We're conducting research among the business community on behalf of the U.S. Department of Commerce and I'd like to ask you a few questions. This is not a sales call of any kind. First, I would like to see if you qualify for this research study..

A. (RECORD GENDER. DO NOT ASK.)

01 Male  GET A MIX

02 Female

B. (RECORD COMPANY SIZE FROM SAMPLE. DO NOT ASK.)

01 Small  MAY QUALIFY FOR “SMALL” GROUP

02 Medium  MAY QUALIFY FOR “MEDIUM” GROUP

03 Large  MAY QUALIFY FOR “LARGE” GROUP

1. Are you the person in your firm responsible for completing government requests for business information? (READ LIST.)

01	Yes		CONTINUE
02	No		ASK TO SPEAK TO THAT PERSON AND BEGIN BY READING INTRODUCTION.

1A. Which statement best describes your role in completing government requests for business information?

01	You compile the information and complete request yourself
02	You along with others in your firm compile the information and complete request
03	You have overall responsible of submitting the request, but you assign others to actually compile the information

2. How long have you been employed in your current position? (READ LIST.)

01	Three years or less		ACCEPT NO MORE THAN 3 PER GROUP
02	More than three years.		CONTINUE

2. How many units does your business have? (DO NOT READ LIST.)

01	1 or 2 units		MAY QUALIFY FOR “SMALL”GROUP
02	More than 2 units		MAY QUALIFY FOR “MEDIUM OR LARGE” GROUP

2. Is this the headquarters location for your company?

01	Yes		CONTINUE
02	No		THANK AND TERMINATE

2. How many employees work at your location? (READ LIST.)

01	Less than 5		THANK AND TERMINATE
02	5 to 19
03	20 to 149
04	150 to 299
05	300 or more

2. Would you classify your business as primarily being engaged in: (READ LIST.)

01	Retail Trade,		CONTINUE
02	The Service Industry,		CONTINUE
03	Manufacturing, or		CONTINUE
04	Some other category		THANK AND TERMINATE

2. What is the type or nature of your business? That is, what does your company do? (PROBE AND CLARIFY.)

2. Is your business involved primarily in providing any of the following: (READ LIST. IF "YES" TO ANY, THANK & TERMINATE.)

	YES	NO
Financial services?	01	02
In advertising, marketing research or public relations?	01	02
Banking?	01	02
Utility services?	01	02

– NOTE: IF YES TO ANY, THANK & TERMINATE.–

2. When, if ever, was the last time that you participated in a market research group discussion or focus group?

01	Within the past 6 months		THANK AND TERMINATE
02	More than 6 months ago		CONTINUE
03	Never		CONTINUE

10. Are you of Hispanic, Latino or Spanish origin?

01	Yes		CONTINUE
02	No		CONTINUE
99	Decline to Answer		CONTINUE

11. Do you consider yourself...?

01	White
02	Black/African American		TRY TO GET A MIX
03	Native American or Alaskan Native
04	Asian
05	Native Hawaiian or Pacific Islander
99	Decline to Answer

INVITE QUALIFIED RESPONDENT TO GROUP.

We are conducting a group discussion among local area business people such as yourself on behalf of the U.S. Department of Commerce regarding their reactions to the business information surveys required by the Federal Government. Please be assured that this will not be a sales meeting. It is a part of a market research study. We think that you will find the discussion very interesting and we'd very much like to include your opinions.

Group A – Small Businesses			0:00 pm
Group B – Medium Businesses			0:00 pm
Group C – Large Businesses			0:00 am/pm

The discussion is scheduled for DATE at 6:00 pm at FACILITY LOCATION. You will be provided XXX for attending as a token of our appreciation for your time and opinions. This discussion will last about 2 hours and refreshments will be served.

Will you be able to attend?

01	Yes	 CONTINUE
02	No	 THANK AND TERMINATE

Also, so that I may send you a reminder and confirmation letter with directions, may I please have your complete mailing address including zip code? Or if you prefer I can send you an email with the information. (PLACE ALL INFORMATION ON FRONT OF SCREENER)

To repeat, the group is scheduled for: DATE at 6:00 pm at FACILITY LOCATION. If for some reason you are unable to attend, please call us immediately so we can invite another participant. We are only inviting a small number of people to the discussion.

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