A Cast of Thousands : Questionnaire

This survey is being run on behalf of A Cast of Thousands who are contracted to SBS INSIGHT to provide studio audience members for their weekly TV forums hosted by Jenny Brockie.

By completing the form you will become eligible for selection to participate in one of the forums. The information that you are providing will enable them to determine whether you fit their needs for a specific program, and will give them your contact details. Participants will receive $50 to help with transport costs.

1. Name

2. Suburb

3. State

4. Residential Postcode

5. Age group

6. Gender

7. Cultural Background
Please state in no more than 50 words what your cultural or ethnic background is. For example, Anglo Australian; Anglo Irish Australian; Second generation Italian Australian; overseas born Greek Australian etc.

8. Community, lobby or political groups
Please state in no more than 50 words if you belong to any lobby groups, community groups or political parties, and what they are. For example, Greenpeace; Liberal Party of Australia; Anglican Church. These do not need to be comprehensive but may help us to decide whether we would like to approach you.
N/A

9. Special interests
Please state in no more than 50 words if you have any special interests. For example, Fly fishing; Lawn Bowls; Reading; Rainforest Preservation Society; Sporting Shooters etc. These do not need to be comprehensive but may help us to decide whether we would like to approach you.
N/A

10. Daytime Telephone Number (this may be used to contact you)

11. Email address (this may be used to contact you)