Special Programs Participant Survey
In the past 12 months, have you:
Attended live jazz performance? Yes/No
Attended live orchestra performance? Yes/No
Attended live performance of other types of music? Yes/No
Attended live ballet or modern/contemporary dance? Yes/No
Attended live performances of other types of dance? Yes/No
Attended live opera performance? Yes/No
Attended live plays or musicals? Yes/No
Visited an art museum or gallery? Yes/No
Visited a historic house or monument? Yes/No
Read a book? Yes/No
How many festivals, parades, street fairs or neighborhood events have you attended in the past 12 months?
Have you ever received arts instruction or taken art classes in music, dance, theater, the visual arts, creative writing or crafts? If yes, did you take these classes: [please check all that apply]
in elementary school?___ in middle or high school?____ in college?___
in private classes? ____
How often do you personally engage in creative activities such as playing a musical instrument, dancing, performing in a play, singing in a choir, creative writing, making jewelry, knitting, sewing, drawing, or painting?
Never ___ Occasionally ____ Monthly ______ Weekly _______ Daily _______
This festival…
… introduced me to styles of art that are new to me agree disagree
… allowed me to interact with artists agree disagree
… is an important part of the life of my community agree disagree
After attending this festival, I think that I will…
… come again next time agree disagree
… attend arts events more regularly agree disagree
… attend new kinds of arts events,
different from what I am used to agree disagree
… seek out new kinds of art for myself or my family
to experience agree disagree
… seek out new ways for myself or my family
to create and share artwork agree disagree
Gender: [ ] Female [ ] Male
Which category includes your age?
[ ] 12 and under [ ] 25-34 [ ] 55-64
[ ] 13-17 [ ] 35-44 [ ] 65-74
[ ] 18-24 [ ] 45-54 [ ] 75 and over
Which of the following describe your ethnicity? Please select only one.
[ ] Hispanic or Latina/o
[ ] Not Hispanic or Latina/o
Which of the following describe your race? Please select one or more.
[ ] American Indian or Alaska native
[ ] Asian
[ ] Black or African American
[ ] Native Hawaiian or other Pacific Islander
[ ] White
What is your native/first language? ______________
Including yourself, how many people live in your household? _____
How many under age 18? _______
How many children under age 18 are attending with you today? _______
What is your home zip code? __________
What is the highest level of education you have completed?
[ ] elementary school
[ ] high school graduate or GED
[ ] junior/community college or technical school
[ ] four-year college or university
[ ] post-graduate
Which category includes your total household income last year?
[ ] up to $25,000 [ ] $50,000-$99,999 [ ] $150,000 and above
[ ] $25,000-$49,999 [ ] $100,000-$149,999
File Type | application/msword |
Last Modified By | neaprofile |
File Modified | 2009-04-10 |
File Created | 2009-04-08 |