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* 1. Which Senior Center do you attend?

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* 2. Age

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* 3. Gender

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* 4. Race

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* 5. Household Composition. Do you live...

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* 6. How did you learn about our services at the center?

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* 7. How long have you been receiving services provided by the Senior Center?

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* 8. Are you participating in any on-site, in-person activities?

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* 9. If you are receiving services remotely (printed materials, crafts, etc.), do you feel they help you stay informed and connected to the center?

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* 10. Would  you be interested in participating in virtual senior center programming?

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* 11. Do you find our staff courteous and professional?

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* 12. Are you aware that you can make a donation toward our program if you wish?

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* 13. What other activities would you be interested in that are not currently offered at this Senior Center?

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* 14. Overall, how satisfied are you with the programs and services offered by the Senior Center?

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* 15. Do you eat meals provided by the center? If you check No skip questions 16 & 17.

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* 16. Are you satisfied with the....

  Always Sometimes Never
Food Taste
Food Smell
Food Appearance
Food Variety
Food Temperature
Food Service Time

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* 17. Write your comments on the Meal Service here:

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