First Name      Last Name
Email Address
Gender

Female

Male
Birth Date - - (Use 4 digits for the year)
Street      Town/Suburb:
Postcode     State:
(competition winners may be sent prizes by post)
Daytime Contact:
Do you have Pay TV at home?

Yes

No

How much time do you spend viewing Music video clips each week?

Less than 15 minutes
15 - 29 mins
30 mins – 1 hour
1 - 3 hours
More than 3 hours
None

From the list, which Music Channel do you watch the most (Pay TV and Free to Air Television)?

Channel V
Channel [V]2
CMC (Country Music Channel)
MAX
MTV
Sunrise / Today Show
VH1
Video Hits
NONE

Which of the following radio stations do you regularly listen to (for 15 mins of more)…?

HOT FM
Nova
Today Network (2DayFM, Fox FM, B105, SAFM, Perth 92.9, Canberra 104.7, NXFM)
MIX FM
SEA FM
STAR FM
Triple J
Triple M
Vega
Classic Hits
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 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

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