Elysium: An American Fable - Audience Feedback Survey

Getting to know you...

The information you provide below helps us to get to know our audience.

Are you a...

Question Title

* 1. Are you a...

Beta Series Subscriber

Individual Ticket Buyer

Village Originals Supporting Member ($150)

Village Originals Starring Member ($250)

Village Originals Contributors Circle Member ($500)

Village Originals Directors Circle Member ($1,000)

Village Originals Producers Circle Member ($1,500)

Guest of a Village Originals Member

Village Theatre Staff Member

Other (please specify)

You have been attending Village Theatre...

Question Title

* 2. You have been attending Village Theatre...

This is my first visit

Less than a year, but not my first visit

1 to 5 years

5 years or more

You are...

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* 3. You are...

Male

Female

Other

Please indicate your age:

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* 4. Please indicate your age:

Under 25

25-34

35-44

45-54

55-64

65 or over

Would you like to be added to our mailing list?

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* 5. Would you like to be added to our mailing list?

Name:

Address:

City:

State:

ZIP:

Would you like to be added to our E-list?

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* 6. Would you like to be added to our E-list?

E-mail: