REQUIRED INFO

First Name:
Last Name:
Email:
Gender: (select one) Male Female    Year of Birth:   Zip Code:
Location:   I would like movie and event info for the following area (select one) Phoenix Area (incl. Scottsdale, Glendale, etc.) Tucson Area

OPTIONAL INFO
 (For more information on the use of this info, CLICK HERE.)

Tells Us More About Yourself

Mailing Address - Line 1:
Mailing Address - Line 2:
City:   State:     

Phone Number:

Marital Status: (select one) Single, Never Married Married, Significant Other Separated, Divorced Widowed

Number of Children in Your Home:
   Boys                                       Girls
   age 0 - 4 0 1 2 3 4 5                     age 0 - 4 0 1 2 3 4 5
   age 5 - 8 0 1 2 3 4 5                     age 5 - 8 0 1 2 3 4 5
   age 9 - 12 0 1 2 3 4 5                   age 9 - 12 0 1 2 3 4 5
   age 13 - 17 0 1 2 3 4 5                 age 13 - 17 0 1 2 3 4 5

Your Occupation:

Approximate Annual Household Income: (select one) Less than $24,999 $25,000 - $49,999 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $124,999 $125,000 - $149,999 $150,000 or More

Highest Level of Formal education Completed: (select one) Post Graduate Degree College Degree Some College Trade School / Vocational High School / GED Some High School or Less Other  

Ethnicity: (select one) Asian Black  / African American East Indian Hispanic / Latino Native American Pacific Islander White / Caucasian Multi-racial Other    if other:

And About Us:

How did you hear about us? (select one) At Movie Screening Flyer Friend or Colleague Internet Search Engine Invitation to Join Newspaper TRT Staff Radio TV Other   if other:

Any other additional comments: