Schott Survey for Deaf and HH

SURVEY QUESTIONS FOR INDIVIDUALS WHO ARE DEAF / HH
SCHOTT COMMUNITIES FOR PERSON WHO ARE DEAF OR DISABLED
6591 S. Flamingo Road, Cooper City, Fl 33330-3915 (954-434-3306)

The questions below are being asked so we can get an idea of what Deaf/HH people want and what they do not want. Please answer the questions as carefully as you can. ANSWER EACH QUESTION DEPENDING ON HOW YOU FEEL.

1. For the health and safety of your FAMILY, which of the following would you be interested in (mark all that apply):

For the health and safety of your FAMILY, which of the following would you be interested in (mark all that apply): Emergency First Aid

CPR

How to Keep the Home Safe

Knowing and Understanding Signs of Illness

Infant and Baby Care

Problems of Drugs and Alcohol

Understanding Diets for Special Health Problems

Understanding Problems of Children and Teenagers

Understanding Problems of Old Age

2. Regarding FINANCIAL ISSUES, which of the following would you be interested in (mark all that apply):

Regarding FINANCIAL ISSUES, which of the following would you be interested in (mark all that apply): First Time Home Buyer

Refinancing Your Home

Buying or Selling a House

Reverse Mortgage

Hurricane/Flood Insurance

Renters Insurance

How to Manager your Money Wisely

How to Use Newspaper and Computer Coupons

How to Use Credit Wisely

How to Buy Clothes Wisely

How to Buy Household Furnishings and Appliances

How to Buy/Own a Car and Car Insurance

How to Read and Understand Contracts, Guarantees and Warranties

How to Plan for Retirement

How and Why to Have a Will and a Living Will

How to Prevent Identification Theft

How to Get Free Credit Reports and Understanding What They Say

3. Regarding LEARNING NEW SKILLS, which of the following would you be interested in (mark all that apply):

Regarding LEARNING NEW SKILLS, which of the following would you be interested in (mark all that apply): Class on Learning Computer Skills

Class on Learning How to Cook and Reading Recipes

Class on Improving Your Cooking Skills

Class on Playing Poker (Texas Hold-em, Omaha, Stud, Draw)

Class on Playing Blackjack

Class on Exercise and Yoga

Class for Beginning and Advanced Chess

4. Regarding SPECIAL EVENTS, which of the following would interest you (mark all that apply):

Regarding SPECIAL EVENTS, which of the following would interest you (mark all that apply): Expo on Major Pager and VRS Providers (Sorenson, Purple, Z-phone, Sprint)

FCC Guidelines and Their New Developments

A Night for Just Playing Dominoes

Special Feature Length Movies in ASL

Learn More About Americans With Disabilities Act Title I, II, III, IV

Learn More About Florida Association of the Deaf

Learn More About National Association of the Deaf

Learn More About Political Candidates Running for Office

Learn How a Bill becomes a Law

Other ideas or suggestions for classes or events:

5. What time of day is best for you to attend these events?

What time of day is best for you to attend these events? Morning (9 to 11 AM)

Early Afternoon (1 to 3 PM)

Later AFternoon (4 to 6 PM)

Evening (7 to 9 PM)

6. What days are best for you to go to the events?

What days are best for you to go to the events? Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

7. Do you have a car?

Do you have a car? Yes

8. If the class requires a small fee, would you be willing to pay?

If the class requires a small fee, would you be willing to pay? Yes

9. So we can contact you if any of the above events will be offered, may we have your contact information?

So we can contact you if any of the above events will be offered, may we have your contact information? Name:
Address:
Address 2:
City/Town:
State:
ZIP:
Pager:
Email Address:
Phone Number (Please indicate Voice or VP?):

10. Do you need childcare services?

Do you need childcare services? Yes

If Yes, ages of children

Schott Survey for Deaf and HH
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1. Introduction

1. For the health and safety of your FAMILY, which of the following would you be interested in (mark all that apply):

2. Regarding FINANCIAL ISSUES, which of the following would you be interested in (mark all that apply):

3. Regarding LEARNING NEW SKILLS, which of the following would you be interested in (mark all that apply):

4. Regarding SPECIAL EVENTS, which of the following would interest you (mark all that apply):

5. What time of day is best for you to attend these events?

6. What days are best for you to go to the events?

7. Do you have a car?

8. If the class requires a small fee, would you be willing to pay?

9. So we can contact you if any of the above events will be offered, may we have your contact information?

10. Do you need childcare services?

Schott Survey for Deaf and HHExit this survey

1. Introduction

1. For the health and safety of your FAMILY, which of the following would you be interested in (mark all that apply):

2. Regarding FINANCIAL ISSUES, which of the following would you be interested in (mark all that apply):

3. Regarding LEARNING NEW SKILLS, which of the following would you be interested in (mark all that apply):

4. Regarding SPECIAL EVENTS, which of the following would interest you (mark all that apply):

5. What time of day is best for you to attend these events?

6. What days are best for you to go to the events?

7. Do you have a car?

8. If the class requires a small fee, would you be willing to pay?

9. So we can contact you if any of the above events will be offered, may we have your contact information?

10. Do you need childcare services?

Schott Survey for Deaf and HH
Exit this survey