KTIS Music Team Sign Up Note: Federal law prevents your registration if you are under 13 years of age. Thank you! Simply fill in the blanks (all blanks are required) and you'll be registered to give us your opinions. It's that easy! 1 Please Select a Username (username can only be one word) 2 Please select a password 3 Your first name: 4 Your last name: 5 Enter your email address: 6 Gender: Male Female 7 Your birthdate: Month 1 - Jan 2 - Feb 3 - Mar 4 - Apr 5 - May 6 - Jun 7 - Jul 8 - Aug 9 - Sep 10 - Oct 11 - Nov 12 - Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 8 Your zip code: 9 What city do you live in? 10 Which types of stations have you listened to at least once in past week (multiple choices okay): KTIS-FM (98.5) KQRS-FM (92.5) K-Love WCCO-AM (830) KSTP-AM (1500) KNOW-FM (91.1) KEEY-FM (102.1) KTCZ-FM (97.1) KQQL-FM (107.9) 11 Which type of station did you listen to MOST in the past week (choose only one): KTIS-FM (98.5) KQRS-FM (92.5) K-Love WCCO-AM (830) KSTP-AM (1500) KNOW-FM (91.1) KEEY-FM (102.1) KTCZ-FM (97.1) KQQL-FM (107.9) 12 How much time do you spend listening to the radio in a typical day? 1 hour or less 1-3 hours More than 3 hours Please listen to these music montages representing three different styles of music and rate them on a 1-5 scale, where 1 is worst and 5 is best. 13 Montage 1 Listen in Flash: Listen in 1 2 3 4 5 14 Montage 2 Listen in Flash: Listen in 1 2 3 4 5 15 Montage 3 Listen in Flash: Listen in 1 2 3 4 5 16 We just want to verify that you know you're signing up to occasionally receive e-mail message from us. Note: All submitted information will remain confidential and will not be used for any other purpose. Yes No