Survey Contest - Tell us about yourself

Complete the form below to be entered for a chance to win a year-long membership to one of our participating organizations (organizations are selected randomly).

	* Required
Name: *
	First	Last
Email Address: *
Zip Code: *
Phone:
	* How did you hear about the Museum Adventure Pass program? Select up to 3 answers. TV Radio Newspaper Library Macy's One of the participating organizations Other   * Did you have a library card before September 2008? Yes Yes, but hadn't used it for a long time No * Have you already or would you visit a museum without the Museum Adventure Pass? Yes No * Are you Male or Female? Male Female * What is your age? under 12 years old 12-18 19-29 30-39 40-49 50-59 60 and over * What is your total household income, including all earners in your household? less than $20,000 $20,000-$50,000 $50,000-$75,000 $75,000-$100,000 $100,000-$150,000 more than $150,000
Terms and Conditions	I Agree to the Terms and Conditions
	One free membership per household. Once you are entered in either contest, your entry stays in the drawing for the duration of the program (through September 2010). Employees and family members of MELSA, participating library systems, participating museum locations or Macy's are not eligible to win.