I agree to participate in a feedback session conducted by the State of New Jersey (including the New Jersey Office of Innovation and the New Jersey Department of Human Services) and the United States Digital Service ("Interviewers").
Interactions and interview(s) are intended to allow the Interviewers to understand your experience applying for benefits online.
I understand that participation in this study is voluntary, and I agree to immediately raise any concerns or areas of discomfort during the session with the Interviewers.
During interview(s), I agree to participate in an online session using my computer, tablet and/or phone. I understand that I may be asked about my experience, opinions, and/or prompted to complete tasks using an online tool.
I understand that the information I provide may inform research, decision making, and the development of improved services and materials. Interviewers may use quotes, statements and insights from the session, but will not attribute information to my name publicly or for other purposes without my permission. I understand and consent to the use and release of the information I provide and a recording of the session by the Interviewers and their affiliates. I relinquish any rights to the recording and information, and understand they may be copied and used by the Interviewers without further permission consistent with this consent.
The State of NJ will take reasonable steps to protect the information you provide us from loss, misuse and unauthorized access, disclosure, alteration, and destruction, but no system is 100% secure so we cannot guarantee the security of all information that you provide.
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As compensation for your participation, you will receive a one-time $40 eGift card delivered to the email address entered below if you are selected for and participate in the full session.
If you have any questions, please contact team@innovation.nj.gov.
Please sign below to indicate that you have read and understand the information on this form and that any questions you might have about the session have been answered.