Acme County Demo Survey

1. Are you a resident of Acme County?
2. What is your zip code?
0 / 5 maximum characters
3. What is your gender?
0 / 15 maximum characters
4. How many people are in your household?
5. What is your age category?
6. Are you a parent or legal guardian of one or more children BETWEEN the ages of 12 - 18?
7. Are you a parent or legal guardian of one or more children UNDER the age of 12?
8. How do you rate your satisfaction with the existing Acme County facilities?
9. Which facilities do you want in Acme County?
Please select your top three (3) choices in order of 1-2-3:
10. Please tell us any ideas or comments you have:
0 / 90 maximum characters
11. Check all the event or activities you are interesting in.
0 / 30 maximum characters
12. Email Address:
Please enter your email if you wish to be apart of the raffle!