NeonCRM


InLiquid Member & Audience Demographic Survey
The InLiquid Member demographic survey is a tool to both help us identify opportunities for our member artists that may be specific to demographics, and apply for grants based on the community we serve. We are often contacted for opportunities specific to location, faith, gender, age, etc. (e.g. PGN, Jewish Exponent, Main Line Times.)
This information will be held strictly confidential, and in no way affects your status as a member or associate, and providing this information is 100% voluntary. Any public use of our demographics will remain strictly anonymous.
Please also feel free to omit any answers you do not feel comfortable sharing.
First Name *
Middle Name
Last Name *
Phone (main contact)
Phone (alternate)
Email *
Address Line 1
Address Line 2
Address Line 3
State
Zip
Address Type
Personal info
Web Site
Gender (mark all that apply)	Cisgender Transgender Woman Man Non-binary Genderqueer Self-identify below Decline to State
Specify self-identified gender
LGBTQ	Yes No
Any specific identifier(s) you would like to share
Birth Date	// (mm/dd/yyyy)
Home Neighborhood
Religious Affiliations	Buddhist Catholic Christian Hindu Islamic Jewish Pagan None Other
Other Religious Affiliations
Ethnic Background	American Indian/Alaskan Native Asian Australian Black/Afro American Caucasian Hispanic/Latino Indian Middle Eastern Pacific Islander
Other Ethnic Background(s)
Nationality
Studio Information
Studio Location	Home Separate studio
Own or Rent	Own Rent
Studio Share	Shared Solo
Studio Neighborhood
Studio Zip Code
Education
Highest Level of Education
Undergraduate Degree
Undergraduate Institution
Undergraduate Grad. Year
Graduate Degree
Graduate Institution
Graduate grad. year
Additional Degree
Additional Degree Institution
grad. year for Additional degree
Employment & Career info
Income based on:	Solely on artwork Part Time Employment & artwork Full Time Employment & Artwork
Employed at:	At An Arts-Related Institution Unrelated to my artwork University / Higher Education
Gallery Representation	Represented by a Commercial Gallery Affiliated with Co-op Unaffiliated Have Agent
Family Size
Family Income Range
Veteran status	Veteran Active Duty Reserves Non-Military
Disability Status	Terminal Illness Blind/Visually Impaired Hearing Impaired Mental Illness Substance Abuse Differently Abled
Permission & Use
Sharing Permission
Anonymous use *	I understand that InLiquid may use anonymized results of this form to assist for grant and sponsorship purposes.
Create User Account
Creating a user account will allow you to keep track of your future member payments and update contact information with us.
Yes, I would like to receive communications from InLiquid by email.
Yes, I would like to receive communications from InLiquid by phone.
Yes, I would like to receive communications from InLiquid by mail.

Neon CRM by Neon One

Timeout Warning

InLiquid Member & Audience Demographic Survey

Personal info

Studio Information

Education

Employment & Career info

Permission & Use

Create User Account