266 Beech Street, Belmont MA, 02478   ---    (617) 993-2970

The Belmont Council on Aging and Beech Street Center continuously seeks to improve and expand its programs. As part of this effort it is important to us to receive feedback from you. We would very much appreciate your taking the time to fill out this simple survey by checking off the appropriate spaces and return to us either by e-mail: nnivvogel@belmont-ma.gov, on-line by going to www.beechstreetcenter.org, by mail or in person at Belmont Council on Aging, 266 Beech Street Center, Belmont, MA 02478. Your response is appreciated by November 15, 2016.

* 1. Have you been to the Beech Street Center for programs in the past year? 

* 2. Think about your life since you started attending the Beech Street Center. Below are some ways that senior centers might make a difference. Please put a check in the box that best matches your response for each statement. 

Because I go to the Beech Street Center I…

  Strongly Agree Agree About the Same Disagree Strongly Disagree N/A
a) See friends more often/make new friends
b) Have learned about services and benefits
c) Am more physically active
d) Would recommend the center to a friend or family member

* 3. Please tell us in what ways participating in the senior center has changed your life.

* 4. What changes would you make to the programming at the center?

* 5. Beech Street Center hours

  Yes No
Are you able to visit the Beech Street Center during our operating hours (Mon-Fri 8 am-4 pm, Tuesdays until 7pm)?
Are you likely to come to special seminars on a weekday evening (7-9 pm)?

* 6. Are you interested in new music programs at the Beech Street Center?

* 7. How did you hear about the Beech Street Center? What first brought you here?

* 8. Where would you most often look for information about Beech Street Center activities? Please check all that apply.

* 9. Please share any other concerns or comments that will help us serve you better.

* 10. Please take a moment to update your contact information and emergency contact person. Keeping good records helps us reach you and your emergency contact when needed! We do not send unsolicited mailers or share your information with third parties outside of Emergency Services Personnel. If you would like to be included in our Nov. 17 raffle drawing, please include your name and a reliable way to reach you below. Online respondents: you are welcome to submit this section by paper if you prefer.