***BURNING MAN 2010 LOW INCOME TICKET APPLICATION***

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.

X
Check this box if you want your ticket held at Will Call at the Box Office of the event.

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):

X
By checking here you agree to the 2010 Terms and Conditions Waiver at the beginning of this application (required for ticket purchase), and agree to read and abide by all of the terms and conditions on the back of your ticket.

LOW INCOME TICKET QUESTIONS FOR 2010 - PAGE 2

1. How many years have you attended Burning Man?

9 years, 2001-2009. 10 years from now will be my 20th burn. :)


2. Why do you feel you need a low cost ticket?

I'm broke and in debt.


3. What do you do to pay the bills and keep the landlord off your back? (i.e. - how do you make a living?)

I don't really. I'm currently living in a motor home.


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.

About $800/mo


5. How do you plan to contribute to Burning Man 2010?

Bring new people
Run my art project and theme camp (if accepted by placement)
Become a ranger
Greet


6. What does the Burning Man community represent to you? (Please answer this even if you have never attended.)

Home


7. Is there anything else you would like to tell us?

This will be my 10th year at Burning Man. In my time, I have brought literally hundreds of new people to experience Burning Man, I have assisted a number of theme camps and even run a theme camp (both registered and not) for the last five years. I have greeted for all nine years and brought a large-scale art project out to the Playa for three years, an art project which took 9 months of full-time work to build. This year I am planning on beginning Ranger Training, so I can connect further to the Burning Man community. I am embedded in Burning Man and Burning Man is embedded in me.

These days I am quasi-homeless and quasi-unemployed, experiencing life by choice as a bit of a gypsy and enjoying such freedom, albeit at the cost of having very little money. It is no irony that the impetus for following this type of lifestyle is in great part inspired by my life at Burning Man. And now, after many sacrifices large and small for the sake of Burning Man, I am at a point in my life where it would be nice if Burning Man could return the favor by easing the burden of coming out to the Playa.

Thanks for your consideration.