2010 Austintown Township Community Survey/Senior Center

The Austintown Township Community center's focus is to enrich the lives of all members of our community by providing a warm, caring, comfortable place for recreation, entertainment, camaraderie and education.

The purpose of this survey is to better understand the needs of our Community regarding a Senior Center. This survey is directed, but not limited to, the opinions and needs of seniors in our community.

Limit one survey per resident. Survey closes May 8, 2010. Questions marked with * are required.

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1. Are you a resident of Austintown?

Are you a resident of Austintown? Yes

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2. What is your age?

What is your age?

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3. Are You:

Are You: Single

Married

Separated/Divorced

Widowed

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4. If there was a senior center in Austintown, how often would you (or a senior you know) make use of it?

If there was a senior center in Austintown, how often would you (or a senior you know) make use of it? Daily

Once or twice a week

Once or twice a month

Never

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5. What would be the reason that you (or a senior you know) would want a senior center in Austintown? (Check all that apply).

What would be the reason that you (or a senior you know) would want a senior center in Austintown? (Check all that apply). Relationships with other seniors...conversations, organized bus trips

Activities to keep me busy...playing cards, board games, bingo

Exercise...aerobics, stationary bikes, treadmill

Health screenings...blood pressure, diabetes testing, etc.

Classes...computer training, cooking, gardening, etc

Senior day care...for a family member

Low cost daily meal/lunch

Other (please specify)

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6. How much, per year, would you (or a senior you know) be willing to pay for a senior center?

How much, per year, would you (or a senior you know) be willing to pay for a senior center?

*
7. What days would you be inclined to use the center?

What days would you be inclined to use the center?

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8. What hours would you be inclined to use the center?

What hours would you be inclined to use the center?

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9. Would you (or a senior you know) need transportation to make use of a senior center?

Would you (or a senior you know) need transportation to make use of a senior center? Yes

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10. Do you (or a senior you know) currently attend a senior center in another community?

Do you (or a senior you know) currently attend a senior center in another community? Yes

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11. Do you (or a senior you know) currently participate in a senior community through church or other organization?

Do you (or a senior you know) currently participate in a senior community through church or other organization? Yes

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12. Are you currently responsible for the care of a family member?

	Child(ren)	Grandchild(ren)	Parent(s)	Other
Yes	*Are you currently responsible for the care of a family member? Yes Child(ren)	Yes Grandchild(ren)	Yes Parent(s)	Yes Other
No	No Child(ren)	No Grandchild(ren)	No Parent(s)	No Other

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13. What is your annual income?

What is your annual income? $20,000-$40,000

$40,000-$60,000

$60,000-$80,000

$80,000 and above

Prefer not to answer

14. Please list any comments/suggestions about the idea for a senior center in Austintown.

Please list any comments/suggestions about the idea for a senior center in Austintown.

15. The following information is optional. It is recommended you fill in this information if you are interested in participating in future surveys for Austintown township

The following information is optional. It is recommended you fill in this information if you are interested in participating in future surveys for Austintown township Name:
Address:
Address 2:
Email:
Daytime Phone:

2010 Austintown Township Community Survey/Senior Center

*1. Are you a resident of Austintown?

*2. What is your age?

*3. Are You:

*4. If there was a senior center in Austintown, how often would you (or a senior you know) make use of it?

*5. What would be the reason that you (or a senior you know) would want a senior center in Austintown? (Check all that apply).

*6. How much, per year, would you (or a senior you know) be willing to pay for a senior center?

*7. What days would you be inclined to use the center?

*8. What hours would you be inclined to use the center?

*9. Would you (or a senior you know) need transportation to make use of a senior center?

*10. Do you (or a senior you know) currently attend a senior center in another community?

*11. Do you (or a senior you know) currently participate in a senior community through church or other organization?

*12. Are you currently responsible for the care of a family member?

*13. What is your annual income?