Listener Survey / Request / Interaction Form
Please take the time to fill our Visitor Survey...
All information is optional, and will be used to better serve the Listening audience of KPLA Klingon Radio.

Personal Information:
Name :
(Klingon, Terran, Screen Name or Alias)
City :
State :
E-mail :

Site Survey:
Would you like to be notified when we update the KPLA site?

How did you hear of KPLA Klingon Radio?

Would you reccomend KPLA Klingon Radio to anyone?

Request / Comment / Question for Announcer:

What would you like to see on KPLA Programming?:

Fandom Inquiry: (Optional)
Are, or were you in another Klingon (or other) Fan-Club?
If Yes, which one?
What kind of group was/is it?
If Selection was Other, Please explain:

How long have you been with them?
What Post do you hold?
What Ranking did/do you hold?
What chapter do you belong to?
What location is it in?
Who operates the chapter (Name, Persona Name, Address, E-mail)?
Thank you for taking the time to fill out the questionaire and the form. Make a selection from the buttons below...