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Make Music Day PHX Venue Registration Form
PLEASE COMPLETE THE 3 SECTIONS OF THE FORM: (1) Contact information (2) Promotional information (3) Survey.
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(1) Contact Information
The next three questions are for communication between you and Make Music Day PHX and will not be made public.
Contact Name
*
Your answer
Contact Phone (555-555-5555)
*
Your answer
Contact E-Mail
*
Your answer
(2) Promotional Information
The following information will be used in the public promotion of events.
Name of Venue
*
Your answer
Website
*
Your answer
Facebook
*
Your answer
Twitter
*
Your answer
Instagram
*
Your answer
On June 21, what times will you be hosting music?
*
Your answer
Venue Street Address
*
Your answer
Venue Phone
*
Your answer
If you have parking spaces at your location, how many do you have?
*
Your answer
Is your venue ADA accessible?
*
yes
no
n/a
In 25 words or less, please give a description of your venue. ( Note: may edit for promotional use.)
*
Your answer
(3) Tell us about you
The following questions are OPTIONAL. This information will help us get to know the articipants we work with a little better so we can articulate who we are serving. Individual responses will NOT be shared.
Age
Choose
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
66 - 75
76 - 85
86 - 100
Prefer not to answer
How many patrons do you serve annually?
Your answer
Do you operate as a nonprofit or for profit entity?
Nonprofit
For profit
Prefer not to answer
Clear selection
Ethnic Background
Choose
Caucasian
Black of African American
Asian
Native Hawaiian of Pacific Islander
Hispanic or Latino
Other
Prefer not to answer
Sex
Choose
Male
Female
Prefer not to answer
Are you an U.S. Veteran?
Choose
Yes
No
Prefer not to answer
What County do you live in?
Your answer
How did you hear about Make Music Day?
*
Your answer
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