Interview Form

Hello,

First, Community Science will not sell, rent or share the personally identifiable information you provide on this form with parties outside Community Science, Inc.

To be involved in the study:

• • You must be between 14 and 26 years old.
  • Not be in school or working.
  • You must live in or be from Bridgeport, Danbury, Hartford, New Haven, Norwalk, Stamford, or Waterbury.
  • The interview will take about an hour and a half.

Please complete the form below if you are interested in participating in the research study.