EBSA Lost and Found Portal
EBSA
Lost and Found Design Review Focus Group Recruitment
Survey
Recruitment survey questions for possible
focus group participants. All fields are required.
Email
Address
We are collecting your email address so we may
contact you to inform you if you have been selected as a
participant.
What city and state are you located in?
Which of the following best describes you?
Asian or Pacific Islander
Black or African American
Hispanic or Latino
Native American or Alaskan Native
White or Caucasian
Multiracial or Biracial
Not listed here
Please select your age group
30 - 40
40 - 50
50 - 60
60 and over
Have you had at least two jobs where your employer provided retirement benefits?
An employer-sponsored retirement plan is a workplace benefit offered by some companies to help provide workers with income in retirement (ex: a pension, 401k, 403b etc.).
Yes
No
I'm not sure.
Do
you have any type of visual impairment that affects your ability to
see colors, shapes, or details?
Please select one option
that best applies to you.
Yes, I have colorblindness.
Yes, I have another visual disability.
No, I do not have any visual impairment.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | [Enter Title] |
Subject | [Enter Subject] |
Author | Office of the Chief Information Officer - United States Departme |
File Modified | 0000-00-00 |
File Created | 2024-09-11 |