|
|
|
First
name |
|
|
| |
Last name |
|
|
| |
Gender |
|
Male Female |
| |
Address |
|
|
| |
Apt./Suite
number |
|
|
| |
City |
|
|
| |
State |
|
|
| |
Postal/Zip code |
|
|
| |
|
Country |
|
|
| E-mail
address |
|
|
| City
I live closest to:
(if not in list select 'other' and enter
city)
|
|
other city/area |
| Birthday
|
|
mm-dd-yyyy |
| Phone
number (with area code) |
|
|
| Mobile
phone number |
|
|
| Preferred
IM service |
|
|
| IM screen
name |
|
|
| Where
did you hear about Events West? |
|
|
| Highest
Education Level |
|
|
| If
you attended college,
what was your major? |
|
|
| Do you
have a car, a valid driver's license
and current car insurance? |
|
|
| Do
you have a digital camera? |
|
|
| What
genres of music are you into?
(hold down Shift key to select more
than one)
|
|
|
|
What
types of projects would you be interested
in
being involved with? - (check all that
apply) |
|
|
|
|
|
|
|
|
|
|
|
|
| What
are the last 3 CDs you bought?
please seperate using commas (,)
|
|
|
| What
was the last concert you went to? |
|
|
| On average,
how many concerts or clubs do you
go to per month? |
|
|
| What
was the last movie you saw? |
|
|
| What
are your 3 favorite TV shows?
please seperate using commas (,) |
|
|
| What
are your 3 favorite music stores?
please seperate using commas (,)
|
|
|
| What
are your 3 favorite night clubs?
please seperate using commas (,) |
|
|
| Have
you ever been on a street team? |
|
|
If so, briefly describe your experience. |
|
|
| |
|
|
|
|
|
References-
please provide a name |
|
|
References-
please enter their phone# |
|
|
References-
what is their relation to you? |
|
|
| |
|
|
|
