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1. How did you find out about the Tobacco Farm Life Museum?

How did you find out about the Tobacco Farm Life Museum? Local Resident Internet Sign Visitor Center Information from Local Business AAA	TV Newspaper Radio Family Member Friend
Other (please specify)

2. Have you worked on a tobacco farm?

Have you worked on a tobacco farm? Yes

N/A

3. If you have worked on a tobacco farm were/are you the owner, operator or an employee?

If you have worked on a tobacco farm were/are you the owner, operator or an employee? Owner

Operator

Employee

N/A

4. Please rate your visit

	Excellent	Good	Mediocre	Poor
Overall Experience	*Please rate your visit Overall Experience Excellent	Overall Experience Good	Overall Experience Mediocre	Overall Experience Poor

Comments and Suggestions

5. Please help the museum provide accurate information for grants and community assistance programs by giving an estimated total income from this event.

Please help the museum provide accurate information for grants and community assistance programs by giving an estimated total income from this event. $0-$500

$501-$1,000

$1,001+

I do not wish to provide this information

Comments

6. If you would like to receive information on upcoming events, newsletters and gift shop specials please provide the following information.

If you would like to receive information on upcoming events, newsletters and gift shop specials please provide the following information. Name:
Company:
Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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