Juror Signup

We value your privacy and assure you that your email address and other account information are strictly for OnlineVerdict.com use. The following information is required for us to send you checks for payment, send you email notices to review cases, and to verify your eligibility to serve as a juror. You only need to provide the following information once because it will be stored in your OnlineVerdict.com juror profile which you may update whenever you return to the site. Your personal, identifiable information will not be revealed to the participating attorneys or any third-party. It will be held in the strictest confidence in accordance with our privacy policy. All information is required!

Please note that jurors are only allowed to sign up once in our database. Duplicate accounts will be deleted.

First Name:	*
Last Name:	*
Address:	*
Address 2:	Optional
City:	*
State:	Please Select a State >>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming*
Zipcode:	*
County:	Please Select a State First * No counties listed?
Lived in County Since:	Please Select >>2010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926 *
Day Phone:	*
Evening Phone:	*
E-Mail Address:	Please input a valid e-mail address. It is used to notify you of cases that you are eligible to participate in. Your e-mail address will also be your login ID. This information will not be shared with any third party. *
Retype E-mail Address:	*
Gender:	Male Female*
Birthdate:	123456789101112 / 12345678910111213141516171819202122232425262728293031 / Please Select >>20052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926 *
Are you a U.S. Citizen?	Yes No*
Do you have a current valid driver's license or State ID?	Yes No* If yes, then state issued: Please Select a State >>AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
Are you a registered voter?	Yes No*
Do you read, write and understand English without assistance?	Yes No*
Have you ever been convicted of a felony?	Yes No*
Ethnic Background:	Please Select >>White/CaucasianBlack/African-AmericanAsian-AmericanHispanic/LatinoNative AmericanOther *
Highest Level of Education:	Please Select >>Less than High SchoolHigh School Graduate or GEDVocation/Technical SchoolSome College/Associate's DegreeCollege Degree (BA/BS)Some Graduate StudyGraduate Degree *
Current Employment Status:	Please Select >>Employed (Full Time)Employed (Part Time)Self EmployedHomemakerRetiredStudentDisabledUnemployedOther *
How would you characterize your occupation?	Please Select >>Blue CollarClericalSalesServiceProfessionalWhite CollarStudentHomemakerOther *
Do you work in any of these industries?	Please Select >>Insurance BrokerInsurance SalesInsurance AdministrationInsurance Adjustor/ClaimsRadio/Television/Print MediaPrivate InvestigationNo, I do not work in these industries *
Are you or have you ever been associated with the legal industry?	Please Select >>Current or Former Law StudentCurrently or Formerly Practiced LawLegal Assistant (Paralegal/Secretary)ClerkLegal Consultant (no law degree)Expert WitnessCourt ReporterCurrent Law Firm Staff (non-litigation)Current Law Firm Staff (firm involved in litigation)Law Degree (never practiced)I have not been associated with the legal industry *
Do you have an immediate family member or significant other that is a lawyer or paralegal involved in civil litigation?	Yes No *
Annual Household Income:	Please Select >>Less than $20,000$20,00 to $29,999$30,000 to $39,999$40,000 to $49,999$50,000 to $59,999$60,000 to $69,999$70,000 or more *
Relationship Status:	Please Select >>Never MarriedMarriedSeparatedDivorcedWidowedLiving with Partner/Significant Other *
Political Stance:	Please Select >>Very LiberalSomewhat LiberalMiddle of the RoadSomewhat ConservativeVery Conservative *
Have you ever been a party in a lawsuit?	Please Select >>Yes, as a plaintiff (the party suing)Yes, as a defendant (the party being sued)Yes, as both (at different times)No *
Have you ever served on a jury before?	Please Select >>Yes, Civil OnlyYes, Criminal OnlyYes, Both Criminal and CivilNo, I have never served *
User Password:	* Your login ID will be your e-mail address. A password is required to login and review cases. Please supply a password with a minimum of 6 characters.
Retype Password:	*
	By checking this box, I am attaching my electronic signature to and agreeing to the Site Usage Agreement for the OnlineVerdict.com Web site and services, and to the OnlineVerdict.com Privacy Policy. I understand that if I do not agree to these Terms and Conditions and the Privacy Policy, I should not check this box, discontinue submission of my personal information, and refrain from using the OnlineVerdict.com Web site and service. *
	I agree to keep confidential the facts and names of all of the parties in cases on which I serve as an OnlineVerdict.com juror. *

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