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Q
10
Marketing
Englewood, NJ
201-541-1144
Contact Us
Judy Hoffstein &
Jill Lipton
Owners
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To receive a bid for your next qualitative research project, simply call us at 201-541-1144 or submit the form below.
I. Company Information
Company Name:
Street Address:
City:
State:
--Select--
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NJ
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OK
OR
PA
RI
SC
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UT
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VA
WA
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WI
WY
Postal Code:
Company Website:
II. Contact Information
First Name:
Last Name:
Title:
Phone:
Fax Number:
Email:
III. Project Specifications
Project Name:
Project Number:
Project Date(s):
Research Type:
--Select--
Focus Groups
IDIs
Dyads
Triads
Other
# of Groups/Sessions:
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Length of Groups/Sessions:
# of Recruits per Group/Session:
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General Recruiting Criteria/Mix:
Age:
Gender:
Income:
Education:
Marital Status:
Employment Status:
Ethnic:
Additional Recruiting Criteria:
Special Instructions/Requests:
IV. Please Respond To Me By:
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