Anchorage Concert Association 2017 Winter Survey

General Questions

Question Title

* 1. Please tell us about yourself to be entered to win tickets to an upcoming show and a dining gift card:

Name:

Address:

Address 2:

City/Town:

State:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

Question Title

* 2. What is your age?

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

Question Title

* 3. To which gender identity do you most identify?

Male

Female

Non-binary

Prefer not to say

Question Title

* 4. What is your ethnicity? (Please select all that apply.)

Native American or Alaska Native

Asian

Pacific Islander

Black or African American

Hispanic or Latino

White / Caucasian

Prefer not to answer

Other (please specify)

Question Title

* 5. What is your yearly household income?

$0-$9,999

$10,000-$29,999

$30,000-$49,999

$50,000-$69,999

$70,000-$99,999

$100,000-$124,999

$125,000-$149,999

$150,000-$174,999

$175,000-$199,999

$200,000-$224,999

$225,000-$249,999

$250,000+