Simply fill in the blanks (all blanks are required) and you'll be registered to give us your opinions. It's that easy! 1 Your first name 2 Your last name 3 Enter your email address 4 My Bridge Radio can stay in touch by sending me email newsletters. Yes No 5 Phone Number: (optional) 6 Street address: (optional) 7 Address Line 2: (optional) 8 City: (optional) 9 State/Provence/Region: (optional) 10 Postal / Zip Code: 11 Country: (optional) 12 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 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 13 Gender Male Female 14 Which of these have you listened to at least once in past week? (select any/all that apply): My Bridge Radio Other Christian Music Radio Adult Contemporary Country Classic Rock Pop/Top 40 Classical Pandora Spotify AccuRadio SiriusXM YouTube Other (specify) 15 Which of these have you listened to most in past week? (select any/all that apply): My Bridge Radio Other Christian Music Radio Adult Contemporary Country Classic Rock Pop/Top 40 Classical Pandora Spotify AccuRadio SiriusXM YouTube Other (specify) 16 On average, do you listen to My Bridge Radio... Less than 1 hour a day 1-3 hours a day 3-5 hours a day More than 5 hours a day 17 What time(s) do you usually listen to My Bridge Radio? Morning (5am-10am) Midday (10am-2pm) Afternoon (2pm-6pm) Evening (6pm-11pm) Overnight (11pm-5am) 18 Where do you usually listen to My Bridge Radio the most? At home At work In the car Other