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SOU Member Survey - 2011

Greetings Members and welcome to our survey! 

Please respond to each question below.  All responses will be kept confidential.  Thanks for your help!

 

 

 
1.

Please provide current contact information so that we may update our records.  Leave any fields blank that do not apply to you.

 


First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

What is your highest level of education? Please check all that apply.

 

Some high school
High school graduate or GED
Some college
Some technical or vocational training
Other  
3.

What is your current employment situation?

 

I am employed on a part-time basis
I am employed on a full-time basis
I am not working and actively seeking employment
I am not working and not seeking employment
4.

What year did you join Step Out?

 

2003
2004
2005
2006
2007
2008
2009
2010
2011
5.

Which of the following Step Out events or activities have you attended?  Please check all that apply.

 

"Culture Vultures" outings
"Flick Friends" outings
Monthly social events
Educational seminars for members
Anniversary party
Holiday party
None of the above
6.

For the Step Out events you have attended, please rate the items listed below.

 

 Excellent Very Good Satisfactory Fair Poor 
Was the invitation clear?
Was the location convenient?
Was the room comfortable?
Were the date and time convenient?
Were the refreshments enjoyable?
Was the cost reasonable?
Was the information useful?
Were the guest speaker(s) competent?
How would you rate the overall experience?
  • Comment:

  • 500 characters left.
7.

How do you typically receive information from or about Step Out?  Please check all that apply.

 

I receive the newsletter; "INSTEP"
I visit stepoutusa.org online
I contact the Step Out staff by phone
I contact the Step Out staff by email
I receive monthly invitations
Other  
8.

Based on your experience, please rate each of the items listed below.

 

 Excellent Very Good Satisfactory Fair Poor N/A 
INSTEP newsletter
Stepoutusa.org website
Phone contact with Step Out staff
Email contact with Step Out Staff
  • Comment:

  • 500 characters left.
9.

What kinds of educational programs would you be interested in? (part 1)

 

 Most interested Very interested Somewhat interested Less interested  
Computers & technology  
Language skills  
Math skills  
Cooking & food preparation  
Arts & crafts  
Personal finance management  
Social skills  
Indoor/apartment gardening  
  • Comment:

  • 500 characters left.
10.

What kinds of educational programs would you be interested in? (part 2)

 

 Most interested Very interested Somewhat interested Less interested  
Dating and marriage  
Sex education  
Personal organizational techniques  
Organizational techniques for work  
Clutter management  
Executive processing skills and how they affect people with learning disabilities  
Using public transportation  
Health & fitness  
  • Comment:

  • 500 characters left.
11.

What kinds of recreational activities would you be interested in?

 

 Most interested Very interested Somewhat interested Less interested  
Concerts  
Theater  
Films  
Sporting events  
Outdoor activities  
Indoor activities  
Museums & exhibits  
Other (please describe)  
  • Comment:

  • 500 characters left.
12.

What would make you more likely to participate in Step Out activities?

 

 

350 characters left.
13.

To help us reduce costs and be kinder to the environment, may we send future editions of INSTEP to you by email?

Be sure that you entered your contact information above.

 

Yes, please send newsletters via email
No thanks, I prefer to receive newsletters via regular mail
14.

Please feel free to share any other comments or questions.

 

 

350 characters left.

Thanks again for your time and input.  When you click "finish" you'll be redirected  to the Step Out USA home page.  Have a great day!