General Information Political/World Affairs Journalists Authors Miscellaneous
Dear Subscriber:

The information requested on this form will be very helpful in tailoring the Philadelphia Speakers Series to your interests.

Your feedback is sincerely appreciated.
 
Please indicate your gender:  Male  Female

Education completed:

Profession:		      
Banking/Financial Business (self-employed) Engineering Media
Biotechnology Computers/High Tech Healthcare Real Estate
Business (corporate) Education (K-12)  Homemaker  Other: 
Business (retail) Education (higher) Law Retired from: 

Interests:		      
 World Affairs  Books/Authors  History  Environment
 American Politics  Entertainment  Business  Sports
 Current Events  The Arts  Science  Other:

Political Party:		      
 Republican  Democrat  Independent  Other: 

2009-2010 Speakers' Evaluations:
  Did you attend?   Evaluation of Speaker   Would you like to hear again?
  Yes No Poor Fair Good Excellent Outstanding Yes No
Pervez Musharraf
Jean-Michel Cousteau
Laura Bush
Robert Reich
Mia Farrow
David Brooks
Greg Mortenson

New Subscribers Only: How did you hear about the Speakers Series?
 Brochure in the mail  Was a guest at a lecture KYW, Newsradio 1060 AM  
 Referred by someone  Playbill  Philadelphia Inquirer  
 Widener University  WHYY, 90.9 FM (NPR)  Jewish Exponent  

From which source do you most frequently get your news?
 TV  Radio  Newspaper  Internet


Of the following, which television stations do you watch for news?
   WTXF (Fox 29) MSNBC FOX
  CNN  CBS 3 Other:   
   WPVI (ABC 6)  WPHL (MyPhl 17)  


Of the following, which radio stations do you listen to?
 KYW, Newsradio 1060  WOGL 98.1 (Greatest Hits, 60s, 70s, 80s)
   WBEB 101.1 FM (B101)  WRTI, 90.1 (Classical/Jazz)
   WHYY 90.9 (NPR) Other: 


Of the following, which newspapers do you read?
   Philadelphia Inquirer  Philadelphia Daily News  USA Today
   New York Times  Wall Street Journal  I don't read the paper
   Washington Post  Jewish Exponent Other:  


Which day of the week do you read the newspaper?
   Sunday  Tuesday  Thursday  Saturday Weekends Only
   Monday  Wednesday  Friday  Everyday  


Of the following, which internet sites do you visit for news?
   KYW.com/CBS3.com  NBCPhiladelphia.com Other: 
   MyFoxPhilly.com  Philly.com  


Of the following, which internet sites do you visit for local entertainment?
   Metromix.com  Eventful.com  Philly.com  PhillyFunGuide.com Other:

How would you rate the customer service that you received from the Kimmel Center staff?
 Excellent  Very Good  Good  Fair  Poor

Why do you like the Speaker Series?
 

Do you have any other comments/suggestions?

Name, Address/Email: *All information supplied is strictly for internal use only and will not be sold or shared