Mock Jury Registration

Full Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

County

Phone Number

Format: (000) 000-0000.

E-mail Address

Age

Gender

Race

Education Level

Are you employed?

What is your occupation?

Annual Household Income

Have you ever owned your own business?

Have you ever supervised employees?

Are you a member of a union?

Do you own/rent your residence?

Have you ever served in the military?

How would you describe your political views?

Do you own a gun?

Do you attend religious services?

Do you read a daily newspaper?

Do you watch any television newscast?

Do you have any social media pages?

How many hours per day do you spend on the internet?

Do you believe that there are too many frivolous lawsuits?

Do you believe that the right to sue should be restricted or eliminated?

Do you believe that because there is a lawsuit pending and a trial about to start that someone must be at fault?

Do you think verdicts are generally too high, too low, or no opinion?

Do you think there should be a "cap" on money damages?

Would you believe a doctor or healthcare worker more than some other member of the public?

In general, how do you feel about pharmaceutical companies?

Are you or anyone in your immediate family a lawyer or ever worked in a law firm?

Have you or a member of your family ever been involved in a lawsuit?

If so, were you satisfied with the outcome?

Have you ever been the victim of a professional malpractice?

Have you ever been part of a focus group?

Have you ever served on a jury?

Have you received a notice for jury duty in the last three months?

Would you believe a police officer more than some other member of the public?

How do you feel about police officers?

How do you feel about the banking industry?