community survey - foleyjcs.weebly.com

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JUNIOR CHAMBER COMMUNITY SURVEY Your Junior Chamber (Jaycee) chapter is dedicated to making an impact in your community while providing leadership opportunities for young adults. As a concerned citizen, we would like your input on planning our programs and focus areas for the coming year. Please help us make our efforts as effective as possible by filling out the following survey. Which of the following areas do you feel are lacking and/or attention in our community? Youth Activities: Park/Playground Equipment Youth Sports/Leagues Gun Safety Nature Programs Teen Dances/Social Events Social Issues: AIDS Awareness Gang Awareness Drug Awareness Domestic Violence Assistance for the Needy Community Improvement: City Beautification Roadside Cleanup Emergency Facilities/Resources Volunteerism Attracting a New Business Programs for Senior Citizens: Public Transportation Adopt a Grandparent Assistance to Elderly Senior Socials Youth Mentoring Programs Personal Development: Financial Planning Starting a Business Leadership Dynamics Estate Planning Job Search Other Activities: Family-oriented Activities Government Involvement Voter Registration Festivals, Concerts, etc. Fire Safety Parades, Easter egg hunts, etc. Do you have any personnel suggestions for programs or activities? ______________________________________________________________________________________ ______________________________________________________________________________________ Would you volunteer 2 hours/month toward improving your community? Yes No Maybe Years you have lived in our community: 0-2yrs 2-5yrs 5-10yrs 10-20yrs 20yrs or more Have you heard of Citizen Corp? Yes No Maybe Age group: under 17 18-20 21-39 40-59 60 and over Number of Children: ______ Ages: ___________________________________________________ Would you be interested in learning more about the Junior Chamber? Yes No Maybe Optional Name: _____________________________________________________ Address: ____________________________________________________ ____________________________________________________ Phone: ____________________________________________________

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Page 1: Community Survey - foleyjcs.weebly.com

JUNIOR CHAMBER COMMUNITY SURVEY

Your Junior Chamber (Jaycee) chapter is dedicated to making an impact in your community while providing leadership opportunities for young adults. As a concerned citizen, we would like your input on planning our programs and focus areas for the coming year. Please help us make our efforts as effective as possible by filling out the following survey.

Which of the following areas do you feel are lacking and/or attention in our community? Youth Activities: Park/Playground Equipment Youth Sports/Leagues Gun Safety Nature Programs Teen Dances/Social Events Social Issues: AIDS Awareness Gang Awareness Drug Awareness Domestic Violence Assistance for the Needy Community Improvement: City Beautification Roadside Cleanup Emergency Facilities/Resources Volunteerism Attracting a New Business

Programs for Senior Citizens: Public Transportation Adopt a Grandparent Assistance to Elderly Senior Socials Youth Mentoring Programs Personal Development: Financial Planning Starting a Business Leadership Dynamics Estate Planning Job Search Other Activities: Family-oriented Activities Government Involvement Voter Registration Festivals, Concerts, etc. Fire Safety Parades, Easter egg hunts, etc.

Do you have any personnel suggestions for programs or activities? ____________________________________________________________________________________________________________________________________________________________________________ Would you volunteer 2 hours/month toward improving your community? Yes No Maybe Years you have lived in our community: 0-2yrs 2-5yrs 5-10yrs 10-20yrs 20yrs or more Have you heard of Citizen Corp? Yes No Maybe Age group: under 17 18-20 21-39 40-59 60 and over Number of Children: ______ Ages: ___________________________________________________ Would you be interested in learning more about the Junior Chamber? Yes No Maybe Optional Name: _____________________________________________________

Address: ____________________________________________________

____________________________________________________

Phone: ____________________________________________________