KOFM 102.9

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First Name

Last Name

eMail Address

Gender

Female

Male

Birth Date

- - (Use 4 digits for the year)

Street Number:

Street Name:

Suburb or Town:

State:

Postcode

Daytime Contact:

(Contest or competition winners may be notified by phone)

In an average week, how much time do you spend listening to the radio?

Fewer than five hours per week
Five to 10 hours per week
More than 10 hours per week

Which radio stations have you listened to (for at least 15 minutes) during the past 7 days, including at home, at work, in your car, or on your portable radio player?

KOFM 102.9	105.3 NEWFM	106.9 NXFM	102.1 JJJ
1143 2HD	1233 ABC	Star 104.5	2GO 107.7
SeaFm 101.3	Other

During a typical 7-day week, which ONE radio station would you listen to MOST for music?

KOFM 102.9	105.3 NEWFM	106.9 NXFM	102.1 JJJ
1143 2HD	1233 ABC	Star 104.5	2GO 107.7
SeaFm 101.3	Other

How often would you listen to this style of music?

Style 1
Style 2
Style 3
Style 4
Style 5
Style 6
Style 7
Style 8
Style 9
Style 10

How often do you send/receive email? (personal and/or business):

More than once per day Once per day A few times per week
Once per week A few times per month Once per month

How often do you surf the web?

More than once per day Once per day A few times per week
Once per week A few times per month Once per month

Comments about KOFM 102.9:

You agree to receive email from us containing:
Invitations to participate in online surveys.
Exclusive information about free concert tickets, movie passes, and other cool stuff!
You agree that your registration details may be used in prize draws and exclusive promotions (you could win prizes!)

The contact information you submit is confidential. It will only be used for KOFM 102.9 and will not be provided to any other party. You may remove yourself at anytime. Members must be at least 13 years old. Members are also required to provide truthful information. We will reject duplicate entries or any entry that we discover to be false or fraudulent.

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You can help choose the music you hear on KOFM 102.9Sign up now to join KO FM's Music Jury

You can help choose the music you hear on KOFM 102.9
Sign up now to join KO FM's Music Jury