MOAA Surviving Spouse Survey

Below are questions regarding topics that may interest you as a surviving spouse. Your answers will be used to develop the Surviving Spouse Program for the ArkLaTex Chapter of MOAA. We appreciate your time and effort in completing this survey.

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* 1. Mark in the order of importance the following activities. (1=most important, 2=next and so on)

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* 2. How knowledgeable are you regarding surviving spouse benefits? (1 star meaning no knowledge and 10 stars meaning expert)

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* 3. Have you been on the MOAA Surviving Spouse Webpage?

Yes

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* 4. Are you on Social Media? If so what type

Facebook

Twitter

Snapchat

Instagram

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* 5. Do you currently drive or have reliable transportation?

Yes

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* 6. What location would be preferred?

BUFF Center at Barksdale

Shreveport based location

Bossier City location other than the base

Use of different locations in the Caddo/Bossier Parish Area

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* 7. How often would participation in a Surviving Spouse Program be convenient?

Monthly

Every other Month

Every 3 months

Every 4 months

Every 6 months

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* 8. Please denote an age range.

_________40-49

_________50-59

_________60-69

_________70-79

_________80-99

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* 9. Please enter your contact information if you would like our advocate to contact you.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number