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.

* Required

Name: *

First

Last

Email Address: *

Zip Code: *

Phone:

* How did you hear about the Museum Adventure Pass program?
Select up to 3 answers.

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

* Have you already or would you visit a museum without the Museum Adventure Pass?

Yes

* 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

Winners of the Passport Contest are ineligible to win the online Survey Contest.
Once you are entered in either contest, your entry stays in the drawing for the duration of the program (through September 3, 2009).
Employees and family members of MELSA, participating library systems, participating museum locations or Macy's are not eligible to win this or the passport contest.

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