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Marks Street Survey
Date
*
First Name
*
Middle Initial
Last Name
*
Age
Home Phone
*
Cell Phone
Email Address
*
Address
*
City
*
State
*
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CT
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DE
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UT
VA
VT
WA
WI
WV
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Zip Code
*
Best Way to Contact
Phone
E-mail
Please let us know if you are interested in participating in any of the following activities (check all that apply)
Board Games
Bird Watching
Badminton
Ballroom Dancing
Talent Shows
Tennis / Table Tennis
Line Dancing
Speed Dating
Shuffleboard
Tea Dance
Choir / Singing Lessons
Movies
Word Search (Sudoku)
Karaoke
Horseshoes
Bingo
Scrap Booking
Piano Lessons
Darts
Creative Writing
Poetry
Chair Massage
Stand-up Comedy
Meditation
Herb Gardening
Photography
Day Trips
Card Games
Aerobic Programs
Other Sports Activities
Day Trips (Please Be Specific)
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Card Games (Please Be Specific)
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Aerobic Programs (Please Be Specific)
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Sports Activities (Please Be Specific)
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Please list anything not mentioned above that you would like to see here at Marks Street
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Help us learn a little bit more about our guests by answering the following questions!
Do you use a home computer?
Yes
No
Do you have access to the Internet?
Yes
No
Have you visited our website (http://www.orangecountyparks.net)?
Yes
No
Where did you first hear about our facility?
Characters left: 1800
What is your favorite activity at Marks Street?
Characters left: 1800
What days of the week are you available for activities?
Sunday
Thursday
Monday
Friday
Tuesday
Saturday
Wednesday
What times are best for you?
Mornings 8-11 AM
Afternoon 12 -1 PM
Evenings 5-8 PM
Additional Comment / Suggestions To Help Us Improve
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