Audience Survey What is your gender identity? What is your orientation? What is your age range (years old)? 12 to 20 years 21 to 40 years 41 to 60 years 61 years and over How many children age 0-5 accompanied you to this performance? How many children age 6 to 11 accompanied you to this performance? What is your race? Black or African American White American Indian and Alaska Native Asian Native Hawaiian and Other Pacific Islander Two or More Races Are you of Hispanic origin? Yes No If so, please specify origin. What town do you live in? How many QANC performances did you attend in the past year? 0 1 2 3 4 5 or more How did you hear about this performance? QANC Mailing Social Media Venue Wesbite QANC Website Poster Honoree Participant or Performer Other What extent do you agree this was a quality performance? Strongly Agree Agree Somewhat Agree Disagree Strongly Disagree Did you learn anything from this performance? Yes No What is the likelihood that you will attend future QANC performances? Very Likely Likely Somewhat Likely Not Likely Comments Provide contact information below to be added to our mailing list: Name First Name Last Name Email Mailing Address: Phone (###) ### #### Check to be contacted for opportunities to volunteer or support QANC Check to be contacted for program opportunities for your children Thank you!
