QEII Seniors and Community Centre Feedback Form Survey

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* 1. How often do you visit the Centre?

First time visitor

Once a week

Twice a week

Three times a week

Four times a week

Every day

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* 2. When did you first start visiting the Centre?

Less than a month ago

Between 1 and 3 months ago

Between 3 and 6 months ago

Between 6 and 12 months ago

Between 1 and 5 years ago

More than 5 years ago

More than 7 years ago

More than 10 years ago

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* 3. Which of the following activities/classes/groups do you participate in?

500 Card Game

African Drumming

Art Class

Balance Gym

Bingo

Canasta

Caring Cuppa – Bereavement Support Group

Chat N Do Craft Group

Chess

Darts

English as a Second Language

Euchre & Frustration

Foodbank Van

Indoor Bowls

Justice of the Peace

Knitters & Crochet Group

Laughs & Crafts

Line Dancing

Mah-jong

One-on-One Technology Lessons

Over 50s Gentle Gym

Parkinsons Boxing/Support Group

Pensioners Social Club

Pickle Ball

Pilates

Pole Walking

Rehabilitation Gym

Rummikub

Scrabble

Seniors Action Group

Seniors Recreation Council

Switched on Seniors Geraldton/Be Connected

Table Tennis

Ukulele Dreamers

Visibility Australia

Walking Football

Walking Group

Zumba

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* 4. Which of the following Centre resources do you use?

QEII Lounge

QEII Library

Seniors Online Computer Room/printing facilities

Staff Assistance (e.g. Seniors Card Information, photocopying, etc.)

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* 5. Overall, how satisfied are you with the programming/resources the Centre provides?

Very satisfied

Satisfied

Unsure

Dissatisfied

Very dissatisfied

Comments on specific activities/classes/groups/services/resources the Centre provides.

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* 6. Overall, what best describes your experience with the services/programming the Centre provides?

Much better than expected

Better than expected

Just as expected

Worse than expected

Much worse than expected

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* 7. Regarding your experience with services/programs at the centre, to what extent do you agree with the following statements?

	Agree	Unsure	Disagree	Not applicable
I developed my skills	I developed my skills Agree	I developed my skills Unsure	I developed my skills Disagree	I developed my skills Not applicable
I met people I can talk to	I met people I can talk to Agree	I met people I can talk to Unsure	I met people I can talk to Disagree	I met people I can talk to Not applicable
I learned something new	I learned something new Agree	I learned something new Unsure	I learned something new Disagree	I learned something new Not applicable
I obtained useful information	I obtained useful information Agree	I obtained useful information Unsure	I obtained useful information Disagree	I obtained useful information Not applicable
I will use the things I learned	I will use the things I learned Agree	I will use the things I learned Unsure	I will use the things I learned Disagree	I will use the things I learned Not applicable
I feel more confident	I feel more confident Agree	I feel more confident Unsure	I feel more confident Disagree	I feel more confident Not applicable
A service/program/activity has made a positive difference in my life	A service/program/activity has made a positive difference in my life Agree	A service/program/activity has made a positive difference in my life Unsure	A service/program/activity has made a positive difference in my life Disagree	A service/program/activity has made a positive difference in my life Not applicable
Staff were helpful/knowledgeable	Staff were helpful/knowledgeable Agree	Staff were helpful/knowledgeable Unsure	Staff were helpful/knowledgeable Disagree	Staff were helpful/knowledgeable Not applicable

Do you have any comments regarding your experiences at the Centre you’d like to share?

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* 8. How likely are you to recommend the services/programs the Centre provides?

Very likely

Likely

Unsure

Unlikely

Very unlikely

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* 9. Which tools do you use to keep up to date or use to access information on the Centre?

Centre Staff

Posters/flyers

Other Seniors

Centre volunteers

City website

QE2 Seniors Scene Newsletter

Over 50s Geraldton Facebook page

Other (please specify)

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* 10. Which gender do you identify with?

Female

Male

Other

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* 11. Do you consider yourself to have a disability?

Yes

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* 12. Where were you born?

Australia

Other (please specify)

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* 13. Do you speak a language other than English at home?

Yes, I speak...

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* 14. How well do you speak English?

Very well

Well

Not well

Not at all

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* 15. What is your age?

49 or under

50-59

60-69

70-79

80-89

90 or over