Name
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First Name
Last Name
Phone
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Country
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How are you connected to the City of Downey?
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How did you hear about Stay Gallery?
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If "Other", please share:
What past programs have you attended at Stay Gallery?
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Please share any past events and/or moments at Stay Gallery that you found memorable:
What kinds of programs would you like to see more of at Stay Gallery?
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If "Other", please share:
What kinds of art classes/workshops would you/your family be interested in attending?
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If "Other", please share:
What age groups would you/your family participate in?
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What days/times would be ideal for you/your family to attend?
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Feel free to share more specific days/times:
What barriers have prevented you/your family from attending arts and cultural programming?
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Feel free to elaborate further:
How do you get information about local arts and cultural programming?
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If "Other", please share:
If applicable, what types of arts and cultural programming do you currently attend and where?
Local organizations, museums, city events, etc.
Age
0 – 15
16 – 24
25 – 34
35 – 44
45 – 60
60 +
Gender
Agender
Male
Female
Transgender man
Transgender woman
Two spirit
Nonbinary
Intersex
Other
Do you identify as Lesbian, Gay, Bisexual, Trans and/or Queer?
Yes
No
Race / Ethnicity
What is your annual income?
Under $10,000
$10,000 – $25,000
$25,000 – $50,000
$50,000 – $75,000
$75,000 – $100,000
$100,000 – $150,000
$150,000 +
