Survey : Questions

	Thank you for your involvement in the Community Education Program. The responses from this survey will allow us to serve you better. All responses will be kept confidential, and responding to questions is optional.

1.

How did you learn about Chemeketa's Community Education Classes?

Community Ed Schedule mailed to my home

Picked up Community Ed Schedule at Chemeketa Campus

Email from Community Ed

Picked up Flyer at Chemeketa Campus

Flyer was mailed to me

Community Education Website www.chemeketa.edu/cla-
ssforfun

Referred by family, friend or colleague

2.	If you have enrolled in a Community Education Class or Workshop in the past, please tell us about your experience.
	350 characters left.

3.	What do you like best about our program?
	350 characters left.

4.	How can we serve you better?
	350 characters left.

5.	What other class topics would you like to see us provide?
	350 characters left.

6.	What other services would you like to see us provide?
	350 characters left.

7.

How far would you be willing to travel to participate in a Community Education class or workshop? (Please select one)

Less than 5 miles

6 to 10 miles

11 to 15 miles

More than 15 miles

Comment:
500 characters left.

8.

OPTIONAL: Please provide your contact information below if you wish to be entered in a drawing for a FREE Chemeketa Community Education Class valued up to $100 (Summer Term 2012 Only). Three winners will be randomly drawn on Friday, May 25, 2012.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

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