FIRST NAME:(Required)

LAST NAME: (Required)

ADDRESS 1:(Optional)

MALE / FEMALE: (Required)

male
female

ADDRESS 2: (Optional)

AGE: (Required)

CITY: (Required)

PROVINCE / REGION: (Optional)

POSTCODE:(Optional)

COUNTRY: (Required)

E-MAIL: (Optional)

CELLPHONE / MOBILE NUMBER:
(Optional)

VISITING OUR WEBSITE

Is this your first visit to our website?
(Required)

Yes                    No

LISTENING TO OUR STATION

How did you find out about our station?
(Required)

Internet               Advertisement

Radio                  Relative / friend

Other: (Optional)

Do you listen to our station online?
(Required)

Yes                No

What frequency do you listen to us on?
(Required)

4965kHz Make selection Yes No

9865kHz Make selection Yes No

How is our signal strength in your area?
(Required)

I can hardly hear you

Some days it's good, other days it's bad

I can hear you clearly

Other comments: (Optional)

When do you usually tune in? (you can tick more than one box)
(Required)

Morning Make selection Yes No

Afternoon Make selection Yes No

Evening Make selection Yes No

How many hours per day (on average) do you listen to us? (Required)

Less than one hour

1 to 2 hours

2 to 3 hours

More than 3 hours a day

Do you enter our competitions?
(Required)

Yes                 No

Do you listen to our news bulletins?
(Required)         

Yes                 No          

Would you like to be able to request songs? (Required)

OUR PROGRAMMES
(Required)

What are your favourite programmes from The Voice Africa?       

What kind of programmes would you like to hear on our station?
(Required)

Name some of your favourite bands / singers
(Optional)

What kind of music do you like listening to?
(Required)

GENERAL QUESTIONS

How can we improve our radio station?
(Optional)

Would you like to find out more about Jesus Christ?
(Required)

YOUR QUESTIONS AND COMMENTS
(Optional)

HOW DID YOU BECOME A FOLLOWER OF JESUS?
(Optional)