Membership Survey
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1.
1
. Please tell us about yourself:
Please tell us about yourself:
Name:
Company:
Address:
Address 2:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP:
Country:
Email Address:
Phone Number:
2
. Why are you a member of Kiwanis?
Why are you a member of Kiwanis?
3
. How long have you been a member?
How long have you been a member?
4
. How often do you attend?
How often do you attend?
5
. Have you ever brought a guest to a meeting?
Have you ever brought a guest to a meeting?
Yes
No
6
. Have you ever invited a guest? Why or why not?
Have you ever invited a guest? Why or why not?
7
. How many Kiwanis sponsored events have you attended
or taken part in during the past year?
How many Kiwanis sponsored events have you attended or taken part in during the past year?
8
. What ideas do you have to increase attendance and
membership?
What ideas do you have to increase attendance and membership?
9
. Would you be willing to support a membership drive?
If so, how many hours would you be willing to volunteer?
Would you be willing to support a membership drive? If so, how many hours would you be willing to volunteer?
10
. Any suggestions for the Membership Committee?
Any suggestions for the Membership Committee?
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