Survey – Hope For You Community Services

Name *

First

Last

Email *

Select your age range *

Which technology do you own or have access to? *

Are you open to receive further training on these devices? *

Do you participate in activities with other Seniors or Seniors groups on a regular basis? *

Do you participate in physical activity daily? *

Are you willing to participate in a physical exercise program? *

Which topics are of interest to you? *

Are you involved in mentoring/praying for a younger person? *

If no to the above, would you be willing to pair up with a younger person to do so? *

How often would you like to meet as a group? *

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I would like to receive additional information on service provided by Hope 4 You!

Any other thoughts/comments?

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