2011 Activation Survey 1. Question Title * 1. Your details Name: Email: Phone: Question Title * 2. Place of residence Upper Hutt Lower Hutt Wellington city Porirua Kapiti Coast Wairarapa Other (please specify) Question Title * 3. Which age group do you belong to? 17 & under 18 - 25 26-35 36-49 50+ Question Title * 4. Which Activation event/programme have you participated in? Lively Parks Lively Places Bike the Trail Bike to Work Breakfast Duathlons ActiveFutures (was futureCLUB) Get Set Go events workshop School Sports Event Kev the Kiwi walks Sport Wellington Buggy Walks Walk the Trail Womens Only Swim Night Pathway to Activity Multi Ethnic Football Tournament Kiwisport Men's Health Programme Schools Fitness Club Professional Development opportunities delivered by Activation Other (please specify) Question Title * 5. What year did you first participate? 2011 2010 2009 2008 2007 or earlier Question Title * 6. What level of activity did you participate in PRIOR to this programme/event? None 1x per week 2x per week 3-4x per week 5-7x per week Question Title * 7. After participating in the above event/s, did you participate in any similar EVENTS? (Activation or otherwise) Yes No If yes, please specify Question Title * 8. After participating in the above programmes/events, did you continue to participate in a form of exercise? Yes No If yes, please specify Question Title * 9. What level of activity do you participate in AFTER this programme/event? None 1x per week 2x per week 3-4x per week 5-7x per week Question Title * 10. How did you hear about the Activation event/programme? Upper Hutt Leader - Activation pages Upper Hutt Leader - WOW pages Upper Hutt Leader - advert Other newspaper Brochure Poster Signboard Activation website WOW website Other (please specify) Question Title * 11. Have you seen the Activation double page spread in the Upper Hutt Leader? Yes No If yes, would you like to see anything else included? Question Title * 12. Have you visited the Activation website www.activation.org.nz? Yes No If yes, is there anything else you would like to see included? Question Title * 13. Would you like to receive the Activation bi-monthly newsletter "Activate"? Yes Please supply your email address Done