The Great Fire Audience Survey 1. Default Section Question Title * 1. Please complete the following information to enter to win tickets to a Lookingglass production. Name: * Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: * Phone Number: Question Title * 2. Would you like to receive information about Lookingglass? Regular Mail E-Mail I would prefer not to receive anything. Question Title * 3. How did you hear about the show? (check all that apply, there are a lot of choices) Brochure/Postcard in the mail Brochure/Postcard picked up at a business Website E-Mail from Lookingglass Facebook YouTube Twitter TheaterMania E-Blast Online through Google Friend/Family Member Chicago Tribune Advertisement Chicago Tribune Review Chicago Tribune (don't remember if ad or review) Chicago Tribune Online Chicago Sun-Times Advertisement Chicago Sun-Times Review Chicago Sun-Times (don't remember if ad or review) Chicago Sun-Times Online Chicago Reader Advertisement Chicago Reader Review Chicago Reader (don't remember if ad or review) Chicago Reader Online ABC TV NBC TV CBS TV CLTV TV FOX TV WTTW TV WYCC TV WBBM Radio WBEZ Radio WXRT Radio Chicago Parent Magazine TimeOut Magazine WHERE Front Desk Magazine This Week in Chicago Magazine Summer festival/event Hotel TV Concierge Chicago Jewish News Jewish United Fund Other (please specify) Question Title * 4. How often do you visit the Lookingglass website? I have never visited the Lookingglass website Less than once a month Once a month Twice a month Three or more times a month Whenever I receive an e-mail or information Question Title * 5. Have you seen a Lookingglass production before? Yes No If Yes, which one(s)? Question Title * 6. Are you currently a Lookingglass subscriber? Yes No Continue
