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.

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* 1. Date

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* 2. Location

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* 3. Name of Program

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* 4. How satisfied were you with your overall experience today?

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* 5. Which organization?

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* 6. How did you hear about the program or event? (please list the organization and check all that apply)

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.

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* 7. What is your gender? (Check your choice)

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* 8. Would you describe yourself as transgender?

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* 9. 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)

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* 10. Which best describes you? (please check all that apply)

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* 11. If children attended with you today, what are their ages? (check all that apply)

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* 12. What is your age?

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* 13. What is your zip code?

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* 14. Comments:

Thank you for taking the time to share your feedback! 
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