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LGBTQ 50+ Alliance Survey

Prepared by OutReach Community Center and the Madison Senior Center

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* 1. Would you like to participate in activities designed for LGBTQ individuals age 50 and older?

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* 2. What is your age?

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* 3. Have you participated in LGBTQ 50+ Alliance activities previously?

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* 4. Who is your interest in activities primarily with?

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* 5. Would you be interested in facilitating a program or activity?

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* 6. What activity or program are you interested in facilitating?

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* 7. Do you have a device (computer, laptop, smart phone, etc) to participate in virtual programs during the COVID-19 restrictions?

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* 8. Are there any barriers or obstacles that prevent you from participating in activities?

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* 9. What are your preferred days of the week for program participation?

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* 10. What time of day do you prefer to participate in programs?

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* 11. Below is a list of current activities. Please check all activities that you might be interested in.

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* 12. Please share your information below if you would like someone from the LGBTQ 50+ Alliance to contact you.

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* 13. Additional Comments

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