Classic System Solutions | Usability Enrollment Form

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Usability Enrollment Form

The information collected is for the sole purpose of matching you with an appropriate activity. We respect your privacy and will not give out your personal information to any other company. We strictly adhere to our posted privacy statement.

* First Name:
* Last Name:
* Street Address:
* City:
* State/Province:
* Zip/Postal Code:
* E-mail:
* Daytime Phone:
* Evening Phone:
* Country:

* Gender:	Male Female
* Age:
You must be 18 years or over to enroll.

* = Required fields

Indicate the highest education level completed:

Grammar School
High School
Associate Degree

Bachelor Degree
Graduate Degree
Ph.D. Degree

In the past year I have:
Purchased a home
Purchased a computer
Purchased a car

In the next year I plan to:
Purchase a home
Purchase a computer
Purchase a car

Name of your organization or employer:

Current job title or position:

Briefly, describe your job responsibilities:

What Internet Browser do you use most?

What is your experience navigating the internet?
Novice Expert

Check all that apply. I use the internet for:

Research
Shopping
Banking

On-line payment services
Investment inquiries/transactions
E-mail

How often do you use internet?

Where do you typically work on computers?

During our sessions, we make video recordings of all or some of the interview. Do you have any objections of being video recorded for our client to review?
Yes No