The Central District Forum for Arts & Ideas presents... Black to the Future: A Black Science Fiction Festival Date: June 11-13, 2004 Home - Schedule - FAQ Locations/Directions/Maps Ticket Information - Writing the Other Workshop Youth Outreach - Sponsors - Volunteer Information Room/Vendors - Links - Survey

BLACK TO THE FUTURE SURVEY FORM

Please take a moment to give us your feedback. Your valuable input will help us improve the quality of our programming. Thank you!

Please check all events that you attended:   Friday Opening Night (Seatte Rep.) Saturday Day Festival (Seattle Center) Sunday Day Festival (Seattle Center) Saturday 5:00 pm Film Panel (Langston) Saturday Film Festival (Langston) 7:00 PM and/or 9:00 PM (Check one or both) Sunday Film Festival (Langston) 5:00 PM and/or 7:00 PM (Check one or both)   Please specify which film(s) and/or program(s) you attended (optional):   Did the event (please choose one):   Exceed your expectations? Meet your expectations? Not meet your expectation?   Please explain below:   What did you like about the program? (check all that apply)   It was entertaining It was relevant The venue was accessible The time and date were convenient I learned something The price was reasonable Other:   In what way, if any, did the program change you? What was especially meaningful?   How did you hear about the program (check all that apply)? E-mail/Website Newspaper/Magazine Ad Radio Friend/Word of Mouth Mailing Other:   Please provide the following demographic information, which is for statistical purposes only.   Zip Code   City   State AK AL AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY   Gender Male Female   Highest level of education (check one):   High School Some College College Graduate Post Graduate Study   Age: Under 18 18-24 25-32 33-45 46-55 56+   Ethnic Background   African/Afro-Caribbean African American Asian/Pacific Islander Hispanic/Latin American White/Caucasian Native American/Indian Mixed Race:   How would you like to receive information about upcoming Forum events?   By mail: Your Name:   Your Address:   City:   State:   AK AL AR AZ CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip:           By E-mail: E-mail Address:   Thank you for your time in filling out this form. Please click submit below.