A little about yourself:
Your Age:
Under 18
19 - 25
26 - 45
46 - 65
65 or older
Your Marital Status (optional):
Married/Common Partner
Single
Which best describes how you are employed:
Student
Retired
Unemployed
Self Employed
Managerial
Professional
Consultant
Sports/Musician/Aritist
Your approximate household income (optional):
<40,000
41,000 - 75,000
76,000 - 100,000
101,000 - 150,000
150,000 +
Do you live in a:
Condominium
Apartment
Townhouse
House
Do you:
Own
Rent
Where do you live?
Markham
GTA (905 York Region)
GTA (905 Other)
GTA (416)
Southern Ontario:
Ontario Other:
Canad Other:
Outside Canada:
Do you wish to be contacted about upcoming jazz events in the area?
( if yes – please indicate your email address OR mailing address below)
Yes
No
Name:
Email:
Mailing address:
Address:
City / Town:
Prov. / State:
Postal Code / Zip:
Country:
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