PLEASE PRINT, COMPLETE AND RETURN APPLICATION TO:
Burning Man
Attn: Low Income Tickets
PO Box 884688
San Francisco, CA 94188-4688
With $160 Money order
1/25/2010 to 5/31/2010
LOW INCOME TICKET QUESTIONS FOR 2010 - PAGE 1
Please be thoughtful & clear in your answers to these questions. If you require additional space for your answers, use the back of your printed application or attach additional pages and reference the question numbers in your responses. And remember: if we can't read your writing we can't award you a ticket.
Name (as it appears on your ID):David Ljung Madison
Email:XXXXXXXXXXXXXXXXXXXXXXXXXX
Home Phone: XXXXXXXXXXXX
Alternate Phone:
Street Address:530 Divisadero St #181
City, State or Province:San Francisco, CA
Zip/Post Code:94117
Country (leave blank if USA):
Address you would like your ticket mailed (ONLY IF DIFFERENT THAN THE ADDRESS LISTED ABOVE):
Name c/o:
Street Address:
City, State or Province:
Zip/Post Code:
Country (leave blank if USA):
Have you moved recently or do we have old addresses for you? Please list any previous addresses we can remove from our database:
Street Address:1553 Fulton St #1
City, State or Province:San Francisco, CA
Zip/Post Code:94117
Country (leave blank if USA):
LOW INCOME TICKET QUESTIONS FOR 2010 - PAGE 2
1. How many years have you attended Burning Man?
2. Why do you feel you need a low cost ticket?
3. What do you do to pay the bills and keep the landlord off your back? (i.e. - how do you make a living?)
4. What is your average monthly take-home income AFTER taxes? Please be honest. We know this is painful, and your answer will be kept confidential. If you are not willing to answer it, please explain your reason why not.
5. How do you plan to contribute to Burning Man 2010?
6. What does the Burning Man community represent to you? (Please answer this even if you have never attended.)
7. Is there anything else you would like to tell us?