Compilation CD Reserve Form
Reserve Your Free Compilation CD!
Please answer a few questions for us.
Your Email:
First Name:
Last Name:
Cell Phone (to join our MOB!:
Zip Code:
State:
Select One
International
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Gender:
male
female
Race:
Select One
Asian/Pacific Islander
Black, Non-Hispanic
Hispanic
Native American/Alaskan Nativ
White, Non-Hispanic
Age Group:
Select One
13-15
16-20
21-25
26-29
30-35
36-39
40-45
46-49
50-55
56-59
60-64
65+
Education:
Select One
Less than 12th Grade
High School Grad
Technical School
Some College
College Grad
Master's Degree
Doctorate Degree
Employment:
Select One
Employed Full-Time
Self-Employed
Employed Partl-Time
Not Employed
Homemaker
Retired
Looking For Work
Disabled
Student
Other
Income:
Select One
Less than 25,000
25-34,999
35-49,999
50-74,999
75,000 and Up
Where did you hear about Dfest?
Select One
Dfest website
Search Engine
Radio
TV
Newspaper
Saw a flyer/postcard/poster
Magazine Ad
Printed Article
Dfest Sponsor
Band playing Dfest
A friend
Dfest staff
Dfest newsletter
MySpace
SonicBids
A Website link
Other
Specificially where?
(ex: Google, The Edge, NonZine, name of a certain band, etc):