Tweet Home Chicago Registration Survey

Thank you for your interest in participating in Tweet Home Chicago: Bird House Design + Build Competition. To register for the competition, please complete this short on-line survey by April 16, 2010.

If you have questions, contact birds@cityofchicago.org.

*
1. Primary Name (can be group or individual):

Primary Name (can be group or individual):

2. If group, list the Team Leader:

If group, list the Team Leader:

3. If group, list individual names (up to 11):

If group, list individual names (up to 11):

*
4. Please insert the following information for the primary contact (must be Chicago resident):

Please insert the following information for the primary contact (must be Chicago resident): Address:
Address 2:
City/Town:
State:
Zip Code:
Email Address:
Phone Number:

*
5. Category (check one)

Category (check one) Adult (any individual or team 18 years of age and older)

Youth (any individual or team under 18 years of age)

6. How did you hear about this contest?

How did you hear about this contest?

*
7. I agree to the following statements (please check each box):

I agree to the following statements (please check each box): By submitting the bird house, I agree that it becomes the property of the City of Chicago.

I and my team members listed will be the primary designers and builders of the house.

8. Additional comments or questions?

Additional comments or questions?

Tweet Home Chicago Registration
Exit this survey

1. Default Section

*
1. Primary Name (can be group or individual):

2. If group, list the Team Leader:

3. If group, list individual names (up to 11):

*
4. Please insert the following information for the primary contact (must be Chicago resident):

*
5. Category (check one)

6. How did you hear about this contest?

*
7. I agree to the following statements (please check each box):

8. Additional comments or questions?

Tweet Home Chicago RegistrationExit this survey

1. Default Section

*1. Primary Name (can be group or individual):

2. If group, list the Team Leader:

3. If group, list individual names (up to 11):

*4. Please insert the following information for the primary contact (must be Chicago resident):

*5. Category (check one)

6. How did you hear about this contest?

*7. I agree to the following statements (please check each box):

8. Additional comments or questions?

Tweet Home Chicago Registration
Exit this survey

*
1. Primary Name (can be group or individual):

*
4. Please insert the following information for the primary contact (must be Chicago resident):

*
5. Category (check one)

*
7. I agree to the following statements (please check each box):