91.3 FM

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First Name

Last Name

Email Address

Gender

Female

Male

Birth Date

- - (Use 4 digits for the year)

Phone:

Address:

Post Code:

NRIC/FIN:

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 of these stations have you listened to in the past week? (select all that apply):

91.3 FM
Class 95
987FM
Power 98
Other

Which of these stations is your overall favourite for music, the one you listen to most when you control the radio?

91.3 FM
Class 95
987FM
Power 98
Other

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