Connected Survey-Spring/Summer Issue

Community Survey - 5 Healthy Towns Foundation

Complete the survey by May 4th at 5 p.m. to be entered into a drawing for a three month membership at the Wellness Center of your choice (Chelsea, Dexter, Manchester, Stockbridge)! If already a member, you will instead receive a $100 gift certificate to go towards Wellness Center Services (personal training, classes, massage, gear)! Provide your email address at the end of the survey to be entered. Surveys completed through May 2018 will still be tallied but not eligible for the prize drawing.

Question Title

* 1. In which community do you live?

Chelsea

Dexter

Grass Lake

Manchester

Stockbridge

Question Title

* 2. What is your gender?

Male

Female

Prefer not to say

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* 3. What is your age?

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* 4. It is important to me that a community activity or event is...

	Not at all		Somewhat		Very
Free or low-cost	Free or low-cost Not at all	Free or low-cost	Free or low-cost Somewhat	Free or low-cost	Free or low-cost Very
Close to home	Close to home Not at all	Close to home	Close to home Somewhat	Close to home	Close to home Very
Physically active	Physically active Not at all	Physically active	Physically active Somewhat	Physically active	Physically active Very
Family Friendly	Family Friendly Not at all	Family Friendly	Family Friendly Somewhat	Family Friendly	Family Friendly Very
On the weekends	On the weekends Not at all	On the weekends	On the weekends Somewhat	On the weekends	On the weekends Very
Educational	Educational Not at all	Educational	Educational Somewhat	Educational	Educational Very
Attended by people I know	Attended by people I know Not at all	Attended by people I know	Attended by people I know Somewhat	Attended by people I know	Attended by people I know Very
Held Outdoors	Held Outdoors Not at all	Held Outdoors	Held Outdoors Somewhat	Held Outdoors	Held Outdoors Very
Specific to my age group	Specific to my age group Not at all	Specific to my age group	Specific to my age group Somewhat	Specific to my age group	Specific to my age group Very

Question Title

* 1. In which community do you live?

Question Title

* 2. What is your gender?

Question Title

* 3. What is your age?

Question Title

* 4. It is important to me that a community activity or event is...

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* 5. Provide your email address if you'd like to be entered into the drawing.