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* 1. What is your age?

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* 2. How did you hear about the program?

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* 3. Do you currently engage in regular physical activity? (30 minutes or more per day for 5 days a week)

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* 4. If you currently engage in regular physical activities, answer the following questions.

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* 5. If you are not currently physically active, how long has it been since you did regular physical activity? (30 minutes or more per day for 5 days a week)

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* 6. After attending an Active SWV program I intent to:

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* 7. Please check all that the reasons that apply that have kept you from being physically active.

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* 8. What activity(s) were part of your Active SWV experience?

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* 9. Before participating in the Active SWV program, had you ever visited the program venue? 

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* 10. How do you benefit from Active SWV programs?

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