Clem Burke Drumming Project

Q.1

Do you play the drums?

Yes
No

Q.2

Are you a professional drummer?

Yes
No

Q.3

Where did you find out about the Clem Burke Drumming Project?

Press
Web
Word of mouth
Other

Q.4

Name

First Name

Last Name

Q.5

e-mail

(e.g. john@hotmail.com)

Q.6

Postal address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Q.7

Date survey was completed

/
MM

/
DD

YYYY