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Neighborhood Events Template

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* 1. Please answer the following:

Gender:

Age:

Household Income:

Primary Language:

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* 2. How often do you attend events in your community/recreation center?

Extremely often

Very often

Moderately often

Slightly often

Not at all often

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* 3. If you do not attend events in community/recreation center, why not?

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* 4. What types of programs/events would you attend if they were held in this community/recreation center?

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* 5. How often do you participate in activities in community/recreation center?

Extremely often

Very often

Moderately often

Slightly often

Not at all often

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* 6. If you do not participate in activities in this community/recreation center, why not?

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* 7. What types of activities/programs would you participate in if they were available in this community/recreation center?