Big Read: Great Lakes Bay Region Visitor Experience Survey
We appreciate your feedback! Your input helps us make our programs and services even better!
Your feedback is anonymous - we won't even ask your name.
Thank you for taking a moment to complete this short survey.
*
1.
Date
(Required.)
2.
Location
3.
Name of Program
4.
How satisfied were you with your overall experience today?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
5.
Which organization?
6.
How did you hear about the program or event? (please list the organization and check all that apply)
Website
Facebook
Twitter
Instagram
Newspaper
Magazine
Radio
Word of Mouth
Other (please specify)
We'd like to learn more about who is participating in our
NEA Big Read: Great Lakes Bay Region
programs. This feedback will help us make sure we're meeting the needs of all people. You can also choose to leave a question blank.
8.
What is your gender? (Check your choice)
Male
Female
Non-Binary / Genderqueer / Third Gender
Prefer to not say
Prefer to self-describe
9.
Would you describe yourself as transgender?
Yes
No
Prefer to not say
10.
Do you or does someone you are visiting with identify as a person with a disability in any of the following areas? (please check all that apply)
Hearing
Vision
Cognitive
Ambulatory / Mobility
Prefer to not say
None of the above
Other (please specify)
11.
Which best describes you? (please check all that apply)
Native American, American Indian, or Alaska Native
Native Hawaiian or other Pacific Islander
Hispanic, Latina, Latino, Latinx, or Spanish Origin
Asian or Asian American
Black or African American
Middle Eastern
White
Prefer to not say
If you don't see yourself in the list provide, please self-describe:
12.
If children attended with you today, what are their ages? (check all that apply)
Less than 5 years old
5 - 10 years old
11 - 13 years old
14 - 17 years old
Not applicable
13.
What is your age?
18-24
25-34
35-44
45-54
55-64
65+
14.
What is your zip code?
15.
Comments:
Thank you for taking the time to share your feedback!
