Our Whole Lives for Adults: Interest & Planning Survey

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* 1. Are you interested in participating in an Our Whole Lives program for adults?

Yes

Other (please specify)

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* 2. OPTIONAL: Your Name (for follow up purposes)?

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* 3. Which of the following age brackets are you currently in? (this is helpful for planning purposes)

18-24

25-44

45-64

65+

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* 4. Our Whole Lives for Adults would most likely be offered on Tuesday OR Wednesday evenings beginning around 6:30 or 7:00 (due to the facilitators & facility schedule). Which of these evenings is MOST conducive to your participation?

Tuesday

Wednesday

Either of these evenings works (generally speaking)

Neither of these evenings works (generally speaking)

Other (please specify)

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* 5. Would the availability of childcare on Tuesday or Wednesday night impact your ability to participate, or otherwise be beneficial?

Yes

Other (please specify)

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* 6. Which of the following formats do you feel would be MOST conducive to your ability to commit to participation?

Weekly 2-hour gatherings for 8 weeks (most likely in October & November)

Bi-weekly 2-hour gatherings spread out over 3-5 months (pending the schedule)

Monthly 2-hour gatherings spread out over 8-9 months

Other (please specify)

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* 7. Which of the following topics would you be MOST INTERESTED in exploring in an Our Whole Lives program (select up to 5)

Sexuality Education

Sexuality & Parenting

Masturbation

Intercourse

Sexual Attraction

Communication

Sexuality & Spirituality

Family

Alternatives to Intercourse

Gender Roles

Gender Identity

Sexuality & Values

Abuse of Sexuality

Sexual Orientation

Relationships

Sex & Aging

Love

Sexuality in the Arts

Other (please specify)

Our Whole Lives for Adults: Interest & Planning Survey

Question Title

* 1. Are you interested in participating in an Our Whole Lives program for adults?

Question Title

* 2. OPTIONAL: Your Name (for follow up purposes)?

Question Title

* 3. Which of the following age brackets are you currently in? (this is helpful for planning purposes)

Question Title

* 4. Our Whole Lives for Adults would most likely be offered on Tuesday OR Wednesday evenings beginning around 6:30 or 7:00 (due to the facilitators & facility schedule). Which of these evenings is MOST conducive to your participation?

Question Title

* 5. Would the availability of childcare on Tuesday or Wednesday night impact your ability to participate, or otherwise be beneficial?﻿

Question Title

* 6. Which of the following formats do you feel would be MOST conducive to your ability to commit to participation?

Question Title

* 7. Which of the following topics would you be MOST INTERESTED in exploring in an Our Whole Lives program (select up to 5)

Question Title

* 8. Is there anything else you’d like for us to know or consider when ﻿considering this program next year?

* 5. Would the availability of childcare on Tuesday or Wednesday night impact your ability to participate, or otherwise be beneficial?

* 8. Is there anything else you’d like for us to know or consider when considering this program next year?