Sign Up! Share Your Views on Local Senior Services

We want to hear your thoughts about funding senior services in our community. We are hosting four small focus groups (two in person and two online) and are looking for people who are willing to share their views.

If selected, you will receive a $100 gift card as a thank‑you.

Please answer a few short questions so we can learn a little about you and know how to reach you. Filling out this form shows your interest, but it does not guarantee you will be chosen.

Your answers will be kept confidential and private.
1.First and Last Name(Required.)
2.Email Address(Required.)
3.Phone Number(Required.)
4.Zip Code(Required.)
5.How old are you?(Required.)
6.What is the best way for you to take part in a focus group?(Required.)
7.Would you need child care for an in-person group?(Required.)
8.How would you describe your political views?(Required.)