CounterPulse Audience Survey
Help shape the future of CounterPulse! Fill out this brief survey letting us know your thoughts about the shows you've seen and about your experience at CounterPulse. This helps us continue to apply for funding that supports our programs and our artists.

Your responses can remain anonymous or you can fill out your email on the last page to be entered into a raffle for a chance to win two tickets to an upcoming Artist Residency Show at CounterPulse!
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Which event at CounterPulse did you attend?
How do you hear about events at CounterPulse? (check all that apply)
Tell us more about yourself!
We want to know who comes to our events so we can better serve the needs of our communities.
How would you describe your Race/Ethnicity? (select all that apply). *
If you prefer to self-identify please write-in the "Other" option which may include any national or tribal affiliations.
必填
How do you identify your gender? (select all that apply) *
If you prefer to self-identify please write in your identifier under "Other.”
必填
Do you identify as LGBTQ+? *
Do you identify as Disabled? *
My age range is: *
Do you work in any of the following fields? *
必填
Which best describes your household income? *
My zip code is *
Write 00000 if you prefer not to disclose
What other local venues in the Bay Area have you visited in the last year?
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