Thank you for helping to evaluate the Senior Activity Center. Your honest responses help us better serve you and provide us with valuable data. 

Please only respond to this survey once per year. We estimate this survey will take you five minutes to complete. 

All text responses may be used without attribution in marketing and fundraising materials.

* 1. Think about your life since you started attending the Montpelier Senior Activity 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 Senior Activity Center, I...

  Strongly Agree Agree Neutral Disagree Strongly Disagree N/A
Do more volunteer work
See friends more often/make new friends
Take better care of my health
Eat meals that are better for me
Have more energy
Feel happier or more satisfied with my life
Have something to look forward to each day
Know where to ask if I need a service such as a ride to the doctor or an aide
Feel more able to stay independent
Feel that the senior center has had a positive effect on my life
Learn new things
Have learned about services and benefits
Am more physically active

* 2. Please tell us how satisfied you are with the Montpelier Senior Activity Center by answering each question with a response ranging from Strongly Agree to Strongly Disagree. Please put a check in the box that best matching your response for each statement.

  Strongly Agree Agree Neutral Disagree Strongly Disagree  N/A
Overall the senior center is clean and attractive.
Staff is professional.
Staff is responsive to my needs.
Staff is friendly and courteous.
Staff is knowledgeable of activities and services.
I feel appreciated as a volunteer.
I am happy with the exercise and fitness classes offered. 
I am happy with the health and wellness education presentations and clinics. 
I am happy with the educational classes offered
I am happy with the recreational and social activities offered.
I am happy with the membership benefits offered.

* 3. I would recommend the senior activity center to a friend

* 4. I participate in the following activities at the Senior Activity Center

* 5. In general, how often do you come to the senior center?

* 6. Approximately how long have you been coming to the Senior Activity Center?

* 7. Please tell us how participating in the Senior Activity Center has changed your life.

* 8. Please provide any additional comments or feedback on the Senior Activity Center.

* 9. What is your age?

* 10. What is your approximate household income? (OPTIONAL)

We'd love to hear from you. If you have more feedback you'd like to share, please don't hesitate to contact us at 223-2518 or stop by the office. Thank you!