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* 1. Do you live in Town limits?

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* 2. Zip Code:

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* 3. Do you live within a 1/2 mile of a public park or recreational facility?

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* 4. What is your gender?

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* 5. What is your age?

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* 6. Ethnicity origin (or Race): Please specify your ethnicity

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* 7. Select the number of persons in your household including yourself who are in the age brackets below:

  1 2 3 4 5 6
14 and under
15-19 years old
20-35 years old
36-45 years old
46-60 years old
61 and over

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* 8. Check below how frequently you or others in your household have visited the following facilities in the past year.

  Regularly Occasionally Rarely Never
Mulberry Park
Rourk Gardens
Riverside Park
Shallotte District Park

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* 9. What is the greatest household barrier to more regular use of a park or recreational facility?

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* 10. Overall, how would you rate the existing recreational facilities within Shallotte?

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* 11. How would you rate your access to a natural body of water (River, Lake, Coast)?

  Private Location Public Location
No Access
Limited Access
Full Access

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* 12. The following is a list of recreation activities that could be considered when updating Mulberry Park.  Rank the importance of each activity with 1 being most important and 5 being least important.  Please consider other members of your household.

  Most Important Least Important
Jogging/Walking Trails
Fishing 
Splash Pad
Bocce Courts
Birding 
Informational Kiosk
Shuffleboard Courts
Canoe/Kayak Launch
Tennis Courts
Open Space/Natural Areas
Picnic Areas
Horseshoe Pits
Sand Volleyball Courts
Outdoor Playground
Dog Park
Outdoor Performance Area
Environmental Center
Outdoor Classroom
Basketball Court

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* 13. The following is a list of recreation activities that could be considered when updating Rourke Gardens.  Rank the importance of each activity with 1 being most important and 5 being least important.  Please consider other members of your household.

  Most Important Least Important
Jogging/Walking Trails
Fishing 
Splash Pad
Bocce Courts
Birding 
Informational Kiosk
Shuffleboard Courts
Canoe/Kayak Launch
Tennis Courts
Open Space/Natural Areas
Picnic Areas
Horseshoe Pits
Sand Volleyball Courts
Outdoor Playground
Dog Park
Outdoor Performance Area
Environmental Center
Outdoor Classroom
Basketball Court

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* 14. The following is a list of recreation activities that could be considered when updating Riverside Park.  Rank the importance of each activity with 1 being most important and 5 being least important.  Please consider other members of your household.

  Most Important Least Important
Jogging/Walking Trails
Fishing 
Splash Pad
Bocce Courts
Birding 
Informational Kiosk
Shuffleboard Courts
Canoe/Kayak Launch
Tennis Courts
Open Space/Natural Areas
Picnic Areas
Horseshoe Pits
Sand Volleyball Courts
Outdoor Playground
Dog Park
Outdoor Performance Area
Environmental Center
Outdoor Classroom
Basketball Court

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* 15. Please list below, any recreation programs or special events that you would like to see offered within Shallotte.

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* 16. Do you use any school or private facilities for recreation or leisure activities?

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* 17. Within the last year have you traveled out of Shallotte to use a recreation facility or program?

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* 18. Would you favor or oppose expanding recreational opportunities in Shallotte?

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* 19. What, if any, sources of funding are you willing to support in order to make improvements, build new facilities, and create programs?  Check all that apply.

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* 20. Would you be willing to pay a nominal fee to attend an event or use a special facility?

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* 21. Which statement describes your relationship to the Town of Shallotte?

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* 22. Check below improvements that could be made to (EXISTING) Mulberry Park.

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* 23. Do you feel that there is a need for additional park space in Shallotte?

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* 24. Additional Comments:

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