Application Form

Becoming a J.Lohr Sensory room panelist is easy! Just follow these 3 steps

Complete the form below and click Apply Now
Check your email. You will receive an email with a link to click and confirm your application.
Please await approval. You will be contacted with the next steps regarding our Panels.

Email Address

This will be your user name to log in to our panelist website.

Re-Type Email Address

These email addresses must match

Password:

Too Short

Re-Type Password:

These passwords must match

First Name:

Last Name:

Address

City

State

Zip Code

Preferred Phone Number:

Alternate Phone Number: (optional)

Date of Birth

Gender:

Male Female Prefer Not to Answer

Allergies:

Yes No

Please list any allergies or food products you prefer not to consume:

What is your ethnic background? (optional)

How did you hear about us?

Please tick to confirm that you have read and agreed with the Terms and Conditions.