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1
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Please Select a Username (user name can only be one word)
Try to use something a little unique like your first and last name combined, your hobby, birthday, etc.
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2
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Please select a password
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3
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Your first name
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4
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Your last name
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5
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Enter your email address
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6
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What is your street address?
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7
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City
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8
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State
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9
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Your zip/postal code
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10
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Gender
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Male
Female
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11
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Your birthdate
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Day |
Month |
Year |
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12
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What is your marital status? (optional)
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Single, never married
Married
Divorced
Widowed
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13
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How many children are in your household?
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14
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Where do you listen to the radio MOST?
(please check only one)
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Car
Home
Work
Other (please indicate where)
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15
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Which of these radio stations have you listened to at least
once in past week? (select any/all that apply):
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Q-92
WKDD 98.1
WAKS Kiss FM 96.5
Mix 94 (94.1)
Rock 107 (106.9)
MY 101.7
Other (please indicate)
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16
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Which station did you listen to most in the past week? (choose only one):
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Q-92
WKDD 98.1
WAKS Kiss FM 96.5
Mix 94 (94.1)
Rock 107 (106.9)
MY 101.7
Other (please indicate)
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17
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How much time do you spend listening to the radio
in a typical day?
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1 hour or less
1-2 hours
More than 2 hours
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18
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What/who is your favorite artist/band?
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19
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Who is your favorite Q-92 DJ?
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20
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What do you like to do in your spare time?
(check all that apply)
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Movies
TV
Sports
Pets
Reading
Computers/Internet
Other
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21
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What is your annual income level? (optional)
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$0-$20,000
$20,001-$35,000
$35,001-$50,000
$50,001-$100,000
$100,001+
Student
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22
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What major purchases do you plan to make
in the next 6 months? (choose all that apply)
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Automobile
Home
Jewelry
Home Electronics
Appliances
Auto Aftermarket Goods/Services
Airline Tickets
Cellular Phone/Service
Furniture
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23
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We just want to verify that you know you're signing up to
occasionally receive e-mail messages from us.
Note: All submitted information will remain confidential
and will not be used for any other purpose.
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Yes
No
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