1. Are you familiar with The Community House?
Yes
No
Not sure

2. Have you attended an event at The Community House?
Yes
No

3. When was the last event you attended at The Community House?
Last week
Last month
Last year
Two years ago

4. If yes, what type of event did you attend?
Antiques Show
Jazzfest
Our Town _ Wine Auction
Winter Holiday Gift Show
Wedding/Shower
Fundraiser/Holiday Party
Meeting
Other

5. Have you attended classes at The Community House?
Yes
No
Thought about it

6. If yes, which class(es) did you attend?



7. In which age category do you fall?
14-17 45-54
18-24 55-64
25-34 65-74
35-44 75+

9.How best can we reach you?
Radio
Television
Newspaper
E-mail
Regular mail

10. What types of special events and/or programs would you like to see at The Community House?
(e.g. International Food Festival, Quilt Show, Events for Singles, Movie Night etc.)



11. Additional Comments



12. About You
Name
E-mail
Address
City State, ZIP
Phone

May we add you to our mailing list and send you our quarterly catalog?
Yes
No

Thank you for your participation!