FORTY5 TELEVISION WITH VARIETY


First Name: *	Last Name: *

Zip Code : *	Phone Number (ex. 2223334444) :

Date of Birth (ex. mm/dd/yyyy): *	E-mail Address: *

How often do you watch Channel 45? *	What do you like to watch on Channel 45? *
Fewer than 5 hours per week 5-10 hours per week More than 10 hours per week Never	Classics (Hogan's Heroes/Star Trek/Cosby Show) Sitcoms (Friends/King of Queens/Scrubs) Primetime Movie Sports (Timberwolves/Minnesota State High School Tournaments) Local Programming (At Issue/On the Road)
What else would you like to see on Channel 45? *	How many community events do you and/or your family attend each year (ex. State Fair, Taste of Minnesota)?*
	1 to 3 events 4 to 6 events 7 or more Never
How many times per week do you watch sports on television? *	How often do you enter on-line contest? *
1 to 2 3 to 4 4 or more Never	1 to 3 times per month 4 to 6 times per month 7 or more times per month Never
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