Question Title

* 1. Where do you live?

Question Title

* 2. Are you a senior?

Question Title

* 3. Do you have a senior parent or family member in Kanata or the surrounding area?

Question Title

* 4. What is your gender?

Question Title

* 5. What language(s) do you speak? (Check all that apply)

Question Title

* 6. What type of services do you think are needed by local Muslim seniors? (Check all that apply)

Question Title

* 7. Would you be willing to participate in a short video for KMA?

Question Title

* 8. For demographic purposes, what is your address? (Optional)

Question Title

* 9. What is the best way to contact you? Please provide us with your phone number and/or email. (Optional)

Question Title

* 10. If you have any other comments or suggestions, please share them here.

T