Share Your Experience

1

1. Which Concert did you attend?

Oregon

Janesville

Milton

Beloit

Edgerton

Clinton

2

2. How would you describe your experience at The Patriotic Concert?* This field is required.

3

3. May we quote your response in future promotional materials?* This field is required.

Yes, with my name and community

Yes, anonymously

No

4

Name and Community* This field is required.

5

4. Would you like to be entered in the drawing for a $100 prepaid Visa gift card?No purchase or donation is necessary. Your response does not need to be positive to qualify.

YESNO

6

Email address* This field is required.Your email address will be used only to contact you if you are selected as the winner, unless you separately choose to receive concert updates.

7

5. Would you like to receive occasional concert updates?

YESNO

8

Email address* This field is required.Your email address will be used only to contact you if you are selected as the winner, unless you separately choose to receive concert updates.