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Section Decsription
Please answer completely and accurately!
1. Are you interested in attending an interracial Singles social event?
Yes Maybe No If no, please skip to 13.
2. Select the location that most interests you!
3. Select the number of days in duration that would be preferable to you.
Up to
4. Would you prefer a . . . ?
5. Select the time of year that best suits your schedule!
6. If you attended, would you be inclined to . . . ?
7. Have you ever attended an organized interracial social function before ?
8. If yes, please describe . . .
9. Which is more important to you ?
10. Misc. Comments
11. Would you like to be notified of any future interracial event offerings ?
12. If yes, enter your email address . . .
13. If yes, enter your full name . . .
*14. Gender: Age: Ethnic:
* = Required!
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