Get Connected! Info & Fun for ALL…

We want your help! Please complete the following information for a FREE entrance to the Expo.

Numbers 1 thru 6 and your e-mail must be answered to get in FREE

Fill-in the info and click send

You will receive an email confirmation, please print it

Bring it to the Senior Lifestyle Expo on August 24th or 25th. This is your ticket to get in FREE

One FREE entry per form completed

NOTE: Name, address and phone is optional. This info is for our purposes only to keep you updated on the Senior Lifestyle Expo. Please know that we do give out or sell our guest names.

Survey for Free Expo Tickets

1. Your Race African American Asian Caucasian Filipino Hispanic/Latino Native American Pacific Islander Other *
2. Your Sex Male Female *
3. Your Education Some High School or Less High School Gradual or Equivalent Some College Undergraduate Degree Postgraduate Degree *
4. Your Annual Income in Dollars Under 25,000 25,000-50,000 50,000-75,000 75,000-100,000 100,000-150,000 150,000-250,000 250,000+ *
5. Your Age 0-12 13-17 18-22 23-35 36-55 56-65 66-75 76-85 86+ *
6. Years You Have Attended the Expo Never 1 Year 2 Years 3 to 5 Years 6 to 9 Years 10+ Years
7. If You Have Attended The Senior Lifestyle Expo Before, What Did You Like Best About It? (optional)
8. What Would You Like to See at The Senior Lifestyle Expo? (optional)
9. Your General Comments About The Senior Lifestyle Expo (optional)
10. Your First Name (optional)
11. Your Last Name (optional)
12. Your Street Address (optional)
13. Your City (optional)
14. Your State (optional)
15. Your Zip Code (optional)
16. New Phone (optional)
17. Email(valid email required)
18. Would you like to receive email updates regarding The Senior Lifestyle Expo? Yes No *

 

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