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* 1. Are you a member of the Roseburg Senior Center?

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* 2.       How often do you come to the center?

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* 3. When you come to the center, what are the reasons that you visit the center? (Check all that apply.)

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* 4. Do you usually come to the center (Check all that apply.)

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* 5.  If the center offered evening classes, events or services would you attend?

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* 6.  How long have you been coming to the center?

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* 7.  How do you get to the center?

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* 8. How interested are you the following programs/activities?

   Very Interested     Might Be Interested Not Interested
BINGO
PINOCHLE
CRIBBAGE
HAND & FOOT
TOURS
WOOD CARVING
PAINTING
POOL
DANCES
HEALTH RELATED EVENTS i.e. HEALTH SCREENINGS, Health Fairs
INFO ON INSURANCES MEDICARE, MEDICAD, FUNERAL PLANNING, e.g.
LIFETIME MEMBERSHIP
OPPORTUNITY TO VOLUNTEER AREA, IF SO WHAT AREAS
SOCIALIZING WITH FRIENDS

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* 9. How often do you volunteer at the center?

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* 10. Did you know that we are self-susstained and you can make donations to help support the center?

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* 11. Have you eaten at the center?

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* 12. If no, please tell us why. Check all that apply. 

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* 13. If you do eat at the center, how satisfied are you with the meals?

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* 14.  How often do you eat meals at the center each week? Please circle the number that best fits.

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* 15. How satisfied you are with the 50+ Cafe?

  Always   Most of the Time  Almost Never   Never N/A
With the way the food tastes
With the way the food smells
With the way the food looks
With the variety of food
That hot foods were hot
That cold foods were cold
Portion size
Those serving were friendly and helpful

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* 16. Do you participate in any other activities outside the center?

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* 17. What aspects of the center do you particularly like and/or dislike?

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* 18. Any other comments and /or suggestions.

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* 19. What is your age group? 

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* 20. What is your gender?

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* 21. Do you live alone?

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* 22. What is your Race/Ethnicity? (Check all that apply) 

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* 23.  Did you know that you can find us on the Internet and find out all about the center, including daily activities?

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* 24. This survey Is anonymous. If you would like to fill the information below, please do so.

If you are interested in the newsletter and calendar of events being emailed to you, please provide your email below.

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* 25. Would you like to be emailed a newsletter and calendar of events 

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