First Name:
Middle Name:
Last Name:
Birthdate: Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024
Are you currently a student enrolled at the University of Wisconsin Milwaukee? Yes No
Do you prefer to watch movies or television shows? Movies! TV Shows! No preference
What genre(s) of media do you most enjoy? (Select at least one) Action Comedy Drama Horror
Do you prefer to watch media at home or in a theater? I prefer my couch I prefer to go out
Do you prefer to binge watch media or space it out? I want to see as much as possible in one sitting I want to take my time to soak it all in
About when was the last time you watched a movie or television show? Today Yesterday Two days to a week Over a week ago
Of the following options, how would you describe your last media viewing experience? (Select at least one) Entered happy Left satisfied Entered with caution Left disappointed Entered neutral Left neutral
Please explain the reasoning behind your moods listed above, in regards to before and after watching the media:
Title of the last movie I watched:
Title of the last television show I watched:
Additional comments: