Incline Village General Improvement District (IVGID) Senior Programs invites you to partake in the 2011-2012 IVGID Senior Program Survey. As a “thank you” for participating we would like to invite you to join in an optional drawing for one of the fabulous prizes listed on the last page. If you would like to be a part of the drawing please complete the contact information section provided at the end of the survey. For more information on the survey and/or IVGID Senior Programs please call (775)832-1310 or email seniorprograms@ivgid.org.

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* 1. What is your age?

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* 2. Gender?

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* 3. Ethnicity?

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* 4. Are you a full time resident of Incline Village or Crystal Bay?

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* 5. If you are NOT a full time resident of Incline Village or Crystal Bay, which season(s) do you typically spend here in Tahoe (select all that apply)?

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* 6. Are you?

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* 7. What is your current living situation?:

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* 8. How many people live in your household?

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* 9. What is your current household income level?

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* 10. Level of Education?

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* 11. Are you currently employed?

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* 12. If retired, do you have any interest in reentering the workforce, either part time or full time?

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* 13. Have you ever participated in an IVGID Senior Program?

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* 14. If yes, how did you first hear about the opportunity?

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* 15. If no, why not?

*For transportation, financial or respite referral assistance please contact IVGID Senior Programs by calling (775)832-1310.

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* 16. Please Check all Activities that are of interest to you

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* 17. Would you be interested in social programs geared towards single seniors?

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* 18. Would you be interested in a low cost Senior Program Membership Club that would
include benefits/discounts at local restaurants and businesses?

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* 19. Do you use social networking sites such as Facebook, Twitter, Linkedin etc.?

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* 20. If Yes, which ones?

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* 21. Do you receive our monthly newsletter, “Senior Moments,” containing upcoming senior programs events and community-wide event announcements?

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* 22. Would you like to receive Senior Moments Newsletter?

If you answered yes to previous question, please complete contact information (question 24) section below.

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* 23. What is the preferred method for you to receive this information?

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* 24. OPTIONAL CONTACT INFORMATION
Please provide in the comment box below: Your Name, Address, Email, and Phone Number. This information will be maintained and used solely by IVGID Senior Programs for promotion of local senior activities and events.

As a thank you for participating in the 2011-2012 IVGID Senior Program Survey the information provided above will automatically be entered into a drawing for one of the fabulous prizes listed below. For more information on the survey and/or IVGID Senior Programs please call (775)832-1310 or email seniorprograms@ivgid.org.
PRIZES
• Program admission to:
> One month of free breakfasts at IVGID Senior Programs Conversation Café ($8 value)
> A Community Snowshoe registration ($10 value)
> A Senior Program Snowshoe Hike registration ($13 value)
> A S.T.E.P. Out Program REGISTRATION of your choice (up to a $20 value)
• Gift Certificate @ Rec. Pro Shop ($20 value)
• A half hour Massage ($50 value)
• A Personal Training Session ($60 value)
• One month senior single Rec. Center membership ($59 value)

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