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Summons Example

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PLEASE READ BELOW BEFORE CONTINUING

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For identifying information, please enter the following:
  • Enter your nine-digit Participant Number (located above and to the right of your name and address or below the bar code on the summons you received in the mail). If you are unable to locate your participant number, click on the "Summons Example" to the left for assistance. You will need to enter this number each time you log in.
  • Enter the first three letters of your last name as it appears on the summons (excluding punctuation and spaces).
  • Enter your Date of Birth. Please enter the birth year as four digits (i.e., 1956).
It will take approximately 10 minutes to complete the questionnaire. Your responses will not be retained if you exit before completion of the entire questionnaire.
Participant Number (Required*)
The first three LETTERS of your last name (excluding hyphens, apostrophes, spaces, etc.)
Date of Birth (4-digit year) (Required*) / /