LISTINGS AND REVISIONS

Company

Address A

Address B

City

State

ZIP or Postal Code

Country other than USA

Telephone number with Area Code

Fax number with Area Code

Cell Phone with Area Code:

E-mail address

Contact: First name

Contact: Last name

Which of the following research facilities
or services are at this location?

Focus Facility
YES --- NO

If "YES"
How many focus suites do you have:

Test kitchen
YES -- NO

Field service
YES --- NO

Mall facility
YES --- NO

On-line Internet research
YES --- NO

Are you, yourself, a Moderator
YES --- NO

If "YES"
Please indicate two
of your specialties below

Specialty 1

Specialty. 2

Number of telephones for interviewing:

Number of CATI stations:

Does your organization provide...

Full Service:
YES ----- NO

Recruiting:
YES ----- NO

Transcribing:
YES ----- NO

Data Processing:
YES ---- NO

Video/On-line Conferencing
YES ----- NO

International research?
YES ----- NO

Ethnography
Yes No

Do you provide a service not listed above
Name of service:

If you have a web site, what is its address:

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