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* 1. Do you live within the Farmville town limits?

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* 2. Including yourself, how many males or females do you have in each age group in your household?

  1 2 3+
Females Under 18 
Males Under 18
Females 18-24
Males 18-24
Females 25-34 
Males 25-34
Females 35-44
Males 35-44
Females 45-54
Males 45-54
Females 55-64
Males 55-64
Females 65+
Males 65+

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* 3. Age of person filling out this survey?

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* 4. Gender of person filling out this survey?

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* 5. Which race/ethnicity best describes you? (Please choose only one.)

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* 6. Which town parks and recreation facilities have you or another person in your household used/visited in the past year? (select all that apply)

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* 7. How would you rate the experience at the town park or facility?

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* 8. Please list any recreation facilities that you or another in your household have used/visited in the past year that is not listed among the town parks and facilities in question #6 (e.g. church or school playground, private gym)

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* 9. How do you normally travel to any recreation facility of park location?

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* 10. Which of the following recreation activities have you or a member of your household participated in the last year? (select all that apply)

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* 11. What recreation activities would you like to see provided or improved by the Town of Farmville? (select all that apply)

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* 12. Which, if any, barriers are there to yourself or others in your household that limits participating in recreation programs or using facilities? (Select all that apply.)

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* 13. Is there any area that we missed in our survey that you would like to see considered? Please share your thoughts on any recreational needs the Town of Farmville is not meeting, please describe below

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