Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
Alternate Phone
E-mail (ex: name@yahoo.com)
Household Income (ex: 100,000)	less than $50,000 $50,001 - $65,000 $65,001 - $80,000 $80,001 - $99,000 $99,000 - $120,000 more than $120,000
Age	18-29 30-39 40-49 50-59 60-69 70-99
How long do you keep the directory?	Less than a week About a month More than a month
Where did you receive Metro Woman Directory?	Doctor's office Bookstore/library Retail location Restaurant Salon/spa Whole Foods Market Other
How often do you visit businesses featured in Metro Woman Directory?	More than 5 per month About once a month Not often

Other comments:

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