Museum Membership Survey

Membership Survey

Please fill out this survey to help us better serve you.
Upon reopening, receive a 1-year General Membership for your participation (a $100 value), unlimited access to the online Docu-Tour during your membership year and one (1) invitation to attend the Grand Opening Ceremony of the expanded Museum (Date TBA).

Thank you to those who previously filled out the survey for the chance to receive a gift card. Winners will be notified shortly.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Demographic Information
Age*

0 - 1718 - 2425 - 3435 - 4445 - 5455 - 6465 - 7475 or more
Ethnicity*

WhiteAsianAmerican IndianBlack or African AmericanMiddle Eastern or North AfricanHispanic Latino or Spanish originNative Hawaiian or Other Pacific IslanderOther
Gender*
Education*

Less than HS diplomaHigh schoolSome collegeBachelors degreeGraduate degreeHigher education
Current Employment*

StudentUnemployed (looking for a job)Unemployed (not looking for a job)Self-employedFull-time employmentPart-time employmentRetired
Household Income*

$0 - $24,999$25,000 - $49,999$50,000 - $74,999$75,000 - $99,999$100,000 - $149,999$150,000 or more
Marital Status*

SingleMarriedDivorcedWidowed
Are you the descendant of a Pullman Porter?*

YesNo
The Museum
Have you ever visited the A. Philip Randolph Pullman Porter Museum?*

YesNo
What children's activities do you want to see from the Museum?*
If you were in charge, what changes would you make to the Museum? This could be programming, exhibits, online or offline suggestions.*
What is your favorite part of the A. Philip Randolph Pullman Porter Museum?*
May we contact you to discuss your answers?*

YesNo
Final Questions
Would you like to join our mailing list?*

YesNo
Your support helps us continue our legacy. Would you like to make a donation to the Museum?*

YesNo
Donation Amount

prevnext( X )
USDDescription
Is there anything else you would like us to know?
Should be Empty:

Membership Survey

Demographic Information

The Museum

Final Questions