Phoenix Perks Survey
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We need your help! The city of Phoenix Human Services Department is currently engaged in planning recreational and social support classes and programs geared toward members of the baby boomer population. The information you provide will help us better understand your needs and will assist us in providing optimal programming.

1. Are you currently (select all that apply):

2. What day(s) of the week are you most likely to take a class (select all that apply):

3. What hours of the day are you most likely to take a class (select all that apply):

4. Please select the following types of classes or activities in which you would be willing to participate (select all that apply):

5. What is your birth year?

6. For statistical purposes only, please provide your Zip Code.

7. Please list any additional comments that will help us further develop the Phoenix Perks programs.

We genuinely appreciate your thoughts and suggestions; we will use them to continue to improve the quality of our programs. Thank you for your input!