Personal -
First Name:

Last Name:

Street Address:

City:  State: Select Arizona Colorado Idaho Nevada New Mexico Utah Wyoming Other  Zip:

Email Address:

Age:

Shameless promotional marketing questions -
1. What type do you drink most often: Select American Lager American Light Lager Pilsner Amber Lager Oktoberfest Bock Belgian Witbier Hefeweizen American Wheat Pale Ale India Pale Ale (IPA) Amber Ale Brown Ale Porter Stout

2. What do you buy most often: Micro brew     National Brands

3. Are you discouraged by beer quality at State Liquor Stores:
Not at all     Not really     A bit     Very  much so  

Most urgent issue facing beer drinkers in Utah:
Quality          Draft keg ban         Alcohol content    
Selection     State markup

No! Don't email me about updates to the sight, and to the petition.

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