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*First Name:
*Last Name:
*E-mail Address:
*Address:
*City:
*State:
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Home Phone:
Date of Birth: Month:    Day    Year: 
*Gender: Female
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Please answer the questions below:
  1. How long do you listen to the radio during any given day?

     

  2. How many radio stations do you listen to in a given day?

     

  3. When do you listen? (Check all that apply)
    6 am-10 am
    10 am-3 pm
    3 pm-7 pm
    7 pm-12 am
    12 am-6 am