International Court System

Official ICC Survey (Members’ Version)

Please answer the following and return your

Answers via email to secretary@imperialcourtaz.org

If there are two of you in the household that are both members of ISEA, each of you please answer and submit.

Membership Information:

1. Gender:

Male __________ Female _________

2. Ethnicity:

Caucasian ____ Latino _____ African American _____ Asian/Pacific Islander ______

Native American _____ Other _____

3. Sexual Orientation:

Heterosexual ______ Gay ______ Lesbian ______ Bisexual ______

Transgender ______ Other _____

4. Age:

14-17 ________ 30-39 ________

18-20 ________ 40-49 ________

21-29 ________ 50+ ________

5. Within the last 12 month period of November 2006 – November 2007 how many times have you used an airline to travel for a(n): ICS function? _______ Personal reason______ Business ______

Please list the destinations and the airlines:

Airline	Pt. of Origin	Destination	No. of Travelers	Personal/Business/Court Related
Airline	Pt. of Origin	Destination	No. of Travelers	Personal/Business/Court Related